Biomedical subjects

S A Yerby

Publications and source records attributed to S A Yerby.

6 recordsLinked to original sources

PubMed1997

The effect of bone quality on pedicle screw loading in axial instability. A synthetic model.

STUDY DESIGN: In this biomechanical analysis of pedicle screw bending moments, custom-fabricated vertebral analogues were loaded in axial compression to produce sagittal bending forces. Moments were measured directly from internally instrumented pedicle screws. OBJECTIVES: To establish the role of cancellous vertebral modulus on pedicle screw bending moments within the vertebral body and the vertebral pedicle. SUMMARY OF BACKGROUND DATA: Pedicle screws are often used to manage axial instability of the spine. Clinical studies report a high incidence of screw bending failure, resulting in kyphosis and pain in some patients. Factors predisposing to bending failure are not well understood, although recent studies have shown that vertebral morphometry is important. METHODS: Axially canullated 7.0-mm pedicle screws, internally instrumented with paired strain gauges, were inserted into analogue vertebrae of uniform dimension. Cancellous modulus was varied from 25-100 MPa. Screws were rigidly mounted to a vertical testing frame, and axial loads were applied to the superior vertebral endplate, producing sagittal bending moments. Moments were recorded from gauges applied in the intrapedicular and intravertebral portions of the screw. Mean moments were compared using a Student's t test, with significance defined as P < 0.05. RESULTS: Cancellous modulus did not affect bending moments experienced in either the intrapedicular or intravertebral portions of the pedicle screws. Gauge accuracy was excellent, and with no gauge drift. CONCLUSIONS: Although small changes in pedicle morphometry can alter screw bending moments significantly, changes in cancellous modulus had no measurable impact on bending moments at these same loads. Bone density is likely to play a limited role in screw bending failure.

Biomechanical Phenomena↗

PubMed1997

Offset laminar hooks decrease bending moments of pedicle screws during in situ contouring.

STUDY DESIGN: A biomechanical study was conducted using cadaver spines to determine the influence of supplemental offset laminar hooks on pedicle screw bending moments and migration during in situ contouring of short-segment pedicle instrumentation. OBJECTIVES: To determine the effects of offset laminar hooks on short-segment pedicle instrumentation constructs during in situ contouring. It was hypothesized that the screw bending moments and screw migration would decrease when offset laminar hooks were used with short-segment pedicle instrumentation. SUMMARY OF BACKGROUND DATA: Clinical studies have implicated screw bending or breakage at the screw hub as failure mechanisms in short-segment pedicle instrumentation constructs used to stabilize thoracolumbar fractures, particularly when rods are contoured in situ. METHODS: Cadaver spines were instrumented using short-segment pedicle instrumentation or short-segment pedicle instrumentation with supplemental offset laminar hooks. The instrumentation was contoured in situ, and screw bending moments were measured at the hub of the screws. Screw migration was measured from lateral radiographs. Comparisons of screw bending moments and migration were made between the two instrumentation configurations. RESULTS: The addition of offset laminar hooks significantly reduced screw bending moments and screw migration during in situ contouring. The mean screw bending moments decreased approximately 30% at the maximum bending angle of 30 degrees (P < 0.05), and the mean screw migration during contouring decreased from 8 degrees to 2 degrees (P < 0.05). CONCLUSIONS: Addition of offset laminar hooks to short-segment pedicle instrumentation decreases screw bending moments and migration of the screws during in situ contouring of the rod. The authors speculate that decrease in loading of the screw will improve durability of the constructs clinically.

Biomechanical Phenomena↗

PubMed1997

The effect of pedicle morphometry on pedicle screw loading. A synthetic model.

STUDY DESIGN: Static nondestructive bending analysis of pedicle screws inserted into vertebral analogues was conducted. Pedicle screw bending load was studied as a function of pedicle morphometry. OBJECTIVES: To determine how sagittal bending moment in pedicle screws is affected by changes in pedicle height, length, and width. BACKGROUND DATA: An unexpectedly high rate of clinical failure has been observed in pedicle screws used in short-segment instrumentation for axially unstable fractures. The majority of screws fail in sagittal bending within the pedicle. To date, little is known of the exogenous factors that affect in situ loads incurred by pedicle screws. METHODS: Synthetic vertebral analogues were fabricated, varying pedicle height, length, or width independently. Pedicle screws internally instrumented with strain gages were used as load transducers to determine screw bending moments within the pedicle and body of the analogue. Analogues were loaded in compression to simulate loading of an unstable burst fracture. RESULTS: Screw bending moments within the pedicle increased incrementally with increasing pedicle length, rising 30% as length increased from 8.0 mm to 12.0 mm. Screw moment increased 20% when pedicle height dropped below 15.0 mm, consistent with a threshold effect. Changes in pedicle width did not affect screw loads within the pedicle. CONCLUSIONS: In situ pedicle screw loads increased significantly as pedicle length increased and as pedicle height decreased. Pedicle screws instrumented internally with strain gages are an effective research instrument allowing measurement of in situ loading along the axis of the screw.

Biomechanical Phenomena↗

PubMed1996

Short-segment pedicle instrumentation. Biomechanical analysis of supplemental hook fixation.

STUDY DESIGN: This biomechanical study of fractures in cadaver vertebrae used specially designed pedicle screws to determine screw strains during loading of two different fixation constructs. OBJECTIVES: The authors determined the relative benefit of adding offset sublaminar hooks to standard pedicle screw constructs to reduce screw bending moments and prevent fixation failure and sagittal collapse. SUMMARY OF BACKGROUND DATA: Clinical studies have demonstrated a high incidence of early screw failure in short-segment pedicle instrumentation constructs used to treat unstable burst fractures. Strategies to prevent early construct failure include longer constructs, anterior strut graft reconstruction, and use of offset sublaminar hooks at the ends of standard short-segment pedicle instrumentation constructs. METHODS: Human cadaver spines with an L1 burst fracture were instrumented with a standard short-segment pedicle instrumentation construct using specially instrumented pedicle screws. Mechanical testing was carried out in flexion, extension, side bending, and torsion, and stiffness and screw bending moments were recorded. Offset hooks were applied initially, then removed and testing repeated. Stiffness data were compared to intact and postfracture results, and between augmented and standard constructs. RESULTS: Addition of offset laminar hooks, supralaminar at T11 and infralaminar at L2, to standard short-segment pedicle instrumentation constructs increased stiffness in flexion by 268%, in extension by 223%, in side bending by 161%, and in torsion by 155% (all were significant except torsion). Sublaminar hooks also reduced pedicle screw bending moments to roughly 50% of standard in both flexion and extension (P < 0.05). CONCLUSIONS: Supplemental offset hooks significantly increase construct stiffness without sacrificing principles of short-segment pedicle instrumentation, and absorb some part of the construct strain, thereby reducing pedicle screw bending moments and the likelihood of postyield deformation and clinical failure.

Aged↗

PubMed1996

Corrosion at the interface. A possible solution to cobalt-chrome heads on titanium alloy stems.

The low-wear characteristics of cobalt-chrome femoral heads matched with the excellent biocompatibility and low modulus of titanium alloy femoral stems constitute the preferred combination used by many orthopaedic surgeons performing total hip arthroplasty. The combination of these materials in a synovial fluid environment, however, has proven to result in extensive crevice corrosion and metallosis of the surrounding tissues. This study investigates an alternative to the conventional mating of dissimilar metals at the head-neck junction. Five cobalt-chrome heads premated with titanium alloy sleeves were investigated by gross examination, dissecting microscopy, and scanning electron microscopy. Examination by both gross examination and dissecting microscope revealed no signs of corrosion. Scanning electron microscope examination revealed slight crevice corrosion in the only head with a +15-mm neck length.

Alloys↗

PubMed1996

A device for the measurement of pedicle screw moments by means of internal strain gauges.

Pedicle screws are commonly used in spinal reconstruction, and failure of pedicle screws due to bending is a significant clinical problem. To measure the moments typically placed on pedicle screws in situ we instrumented 7 mm Cotrel-Dubousset (CD) pedicle screws with internally mounted strain gauges. The screws were designed to measure flexion-extension moments at a single cross-section as dictated by strain gauge placement. It is possible to measure moments of up to 12 Nm at any location along the length of the screw by constructing transducers with varying strain gauge placements. These transducers are capable of measuring moments at points located within the vertebra including the pedicle, which is where failure usually occurs clinically. Transducer output was both linear and reproducible. These transducers are being used to investigate the load transfer characteristics between the pedicle screw and the vertebra. This technique could be applied to investigations of load sharing in reconstruction plates, lag-screws, and cross-locked intramedullary nails.

Biomechanical Phenomena↗