PMID- 26720724
OWN - NLM
STAT- MEDLINE
DCOM- 20160628
LR  - 20170907
IS  - 1932-6203 (Electronic)
IS  - 1932-6203 (Linking)
VI  - 10
IP  - 12
DP  - 2015
TI  - A Biomechanical Comparison of Expansive Pedicle Screws for Severe Osteoporosis:
      The Effects of Screw Design and Cement Augmentation.
PG  - e0146294
LID - 10.1371/journal.pone.0146294 [doi]
AB  - Expansive pedicle screws significantly improve fixation strength in osteoporotic 
      spines. However, the previous literature does not adequately address the effects 
      of the number of lengthwise slits and the extent of screw expansion on the
      strength of the bone/screw interface when expansive screws are used with or
      without cement augmentation. Herein, four designs for expansive pedicle screws
      with different numbers of lengthwise slits and different screw expansion levels
      were evaluated. Synthetic bones simulating severe osteoporosis were used to
      provide a comparative platform for each screw design. The prepared specimens were
      then tested for axial pullout failure. Regardless of screw design, screws with
      cement augmentation demonstrated significantly higher pullout strength than
      pedicle screws without cement augmentation (p < 0.001). For screws without cement
      augmentation, solid screws exhibited the lowest pullout strength compared to the 
      four expansive groups (p < 0.01). No significant differences in pullout strength 
      were observed between the expansive screws with different designs (p > 0.05).
      Taken together, our results show that pedicle screws combined with cement
      augmentation may greatly increase screw fixation regardless of screws with or
      without expansion. An increase in both the number of slits and the extent of
      screw expansion had little impact on the screw-anchoring strength. Cement
      augmentation is the most influential factor for improving screw pullout strength.
FAU - Tai, Ching-Lung
AU  - Tai CL
AD  - Graduate Institute of Medical Mechatronics, Department of Mechanical Engineering,
      Chang Gung University, Kweishan, Taoyuan, Taiwan.
FAU - Tsai, Tsung-Ting
AU  - Tsai TT
AD  - Department of Orthopedic Surgery, Bone and Joint Research Center, Chang Gung
      Memorial Hospital, Chang Gung University College of Medicine, Kweishan, Taoyuan, 
      Taiwan.
FAU - Lai, Po-Liang
AU  - Lai PL
AD  - Department of Orthopedic Surgery, Bone and Joint Research Center, Chang Gung
      Memorial Hospital, Chang Gung University College of Medicine, Kweishan, Taoyuan, 
      Taiwan.
FAU - Chen, Yi-Lu
AU  - Chen YL
AD  - Graduate Institute of Medical Mechatronics, Department of Mechanical Engineering,
      Chang Gung University, Kweishan, Taoyuan, Taiwan.
FAU - Liu, Mu-Yi
AU  - Liu MY
AD  - Graduate Institute of Medical Mechatronics, Department of Mechanical Engineering,
      Chang Gung University, Kweishan, Taoyuan, Taiwan.
FAU - Chen, Lih-Huei
AU  - Chen LH
AD  - Department of Orthopedic Surgery, Bone and Joint Research Center, Chang Gung
      Memorial Hospital, Chang Gung University College of Medicine, Kweishan, Taoyuan, 
      Taiwan.
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20151231
PL  - United States
TA  - PLoS One
JT  - PloS one
JID - 101285081
RN  - 0 (Bone Cements)
SB  - IM
MH  - Biomechanical Phenomena/*physiology
MH  - Bone Cements/*therapeutic use
MH  - Bone and Bones/surgery
MH  - Equipment Design/*instrumentation
MH  - Humans
MH  - Materials Testing
MH  - Osteoporosis/surgery/*therapy
MH  - *Pedicle Screws
PMC - PMC4697834
EDAT- 2016/01/01 06:00
MHDA- 2016/06/29 06:00
CRDT- 2016/01/01 06:00
PHST- 2015/10/14 00:00 [received]
PHST- 2015/12/15 00:00 [accepted]
PHST- 2016/01/01 06:00 [entrez]
PHST- 2016/01/01 06:00 [pubmed]
PHST- 2016/06/29 06:00 [medline]
AID - 10.1371/journal.pone.0146294 [doi]
AID - PONE-D-15-45209 [pii]
PST - epublish
SO  - PLoS One. 2015 Dec 31;10(12):e0146294. doi: 10.1371/journal.pone.0146294.
      eCollection 2015.