Using a Combination of Intralaminar and Pedicular Screw Constructs for Enhancement of Spinal Stability and Maintenance of Correction in Patients With Sagittal Imbalance: Clinical Applications and Finite Element Analysis

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dc.contributor.authorİnanmaz, Mustafa Erkan
dc.contributor.authorKöse, Kamil Çağrı
dc.contributor.authorAtmaca, Halil
dc.contributor.authorÖzkan, Arif
dc.contributor.authorIşık, Cengiz
dc.contributor.authorBaşar, Hakan
dc.date.accessioned2020-04-30T23:46:52Z
dc.date.available2020-04-30T23:46:52Z
dc.date.issued2016
dc.departmentDÜ, Tıp Fakültesi, Cerrahi Tıp Bilimleri Bölümüen_US
dc.descriptionatmaca, halil/0000-0001-5820-6456en_US
dc.descriptionWOS: 000386000400008en_US
dc.descriptionPubMed: 24346054en_US
dc.description.abstractStudy Design:Case series and finite element analysis.Objective:To report the clinical results of using intralaminar screw-rod (ILS) constructs as supplements to regular pedicle screw (PS) constructs in high risk for implant failure patients and to report the results of a finite element analysis (FEA) of this new instrumentation technique.Summary of Background Data:Despite advances in surgery and implantation techniques, osteoporosis, obesity, revision surgeries, and neuromuscular conditions (such as the Parkinson disease) are challenges against achieving solid arthrodesis and maintaining correction. Additional fixation strategies must be considered in these patients. There is only one study in the literature suggesting that ILS can be used as alternative anchor points and/or to increase fixation strength in conjunction with the PSs.Materials and Methods:Five patients (3 male and 2 female) with mechanical comorbidities underwent PS+ILS to treat sagittal imbalance. In radiologic analysis, thoracic kyphosis, lumbar lordosis, and sagittal vertical axis were analyzed. FEA of ILS augmentation technique were carried out.Four different models were created: (1) the full-construct model with ILS+PS 2 levels above and below the osteotomy of T10; (2) only PS 2 levels above and below T10; (3) ILS+PS 1 level above and below the osteotomy; and (4) short-segment PS with only PSs 1 level above and below the osteotomy. The stress/load distributions on the implants in vertebrae were analyzed.Results:The mean age of the patients included in this study was 41 years and the mean follow-up was 28.2 months. A total of 87 PSs and 39 ILSs were used. Both sagittal vertical axis and kyphosis angles showed significant improvements maintained at the latest follow-up. No pseudarthrosis or instrumentation failures were observed. FEA indicated that addition of ILS construct to a PS construct enabled decreased load bearing and increased implant life.Conclusions:Addition of an ILS construct to PS construct decreases osteotomy line deformation and reduces stress on pedicle fixation points, and the combination improves fixation stability over the conventional PS-rod technique.en_US
dc.description.sponsorshipNational Institutes of Health (NIH)United States Department of Health & Human ServicesNational Institutes of Health (NIH) - USA; Wellcome TrustWellcome Trust; Howard Hughes Medical Institute (HHMI)Howard Hughes Medical Instituteen_US
dc.description.sponsorshipNo form of funding has been received in relation to the preparation of the study by the authors including National Institutes of Health (NIH); Wellcome Trust; Howard Hughes Medical Institute (HHMI); and other(s).en_US
dc.identifier.doi10.1097/BSD.0000000000000069en_US
dc.identifier.endpageE427en_US
dc.identifier.issn2380-0186
dc.identifier.issue8en_US
dc.identifier.scopusqualityQ2en_US
dc.identifier.startpageE421en_US
dc.identifier.urihttps://doi.org/10.1097/BSD.0000000000000069
dc.identifier.urihttps://hdl.handle.net/20.500.12684/5330
dc.identifier.volume29en_US
dc.identifier.wosWOS:000386000400008en_US
dc.identifier.wosqualityQ4en_US
dc.indekslendigikaynakWeb of Scienceen_US
dc.indekslendigikaynakPubMeden_US
dc.indekslendigikaynakScopusen_US
dc.language.isoenen_US
dc.publisherLippincott Williams & Wilkinsen_US
dc.relation.ispartofClinical Spine Surgeryen_US
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanıen_US
dc.rightsinfo:eu-repo/semantics/closedAccessen_US
dc.subjectintralaminar screwen_US
dc.subjectspinal deformityen_US
dc.subjectsupplemental fixationen_US
dc.subjectfinite element analysisen_US
dc.subjectimplantation techniquesen_US
dc.subjectimplant failureen_US
dc.titleUsing a Combination of Intralaminar and Pedicular Screw Constructs for Enhancement of Spinal Stability and Maintenance of Correction in Patients With Sagittal Imbalance: Clinical Applications and Finite Element Analysisen_US
dc.typeArticleen_US

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