So far, the fixation in the lower cervical spine through posterior approach technology has commonly been used, besides the lateral screw and pedicle screw techniques, transarticular screw and laminar screw techniques have being paid more attention recently. This article introduced four screw fixation ways in the lower cervical spine through posterior approach and reviewed the recent biomechanics studies of four screw fixation techniques. The biomechanics study includes stabilization, pollout strength, insertion technique, and screw characteristic and so on. Lateral screw and pedicle screw techniques have become an effective internal fixation way for the lower cervical spine instability because of their superior stabilization and higher pollout strength. Transarticular screw fixation has become a new way to fix the lower cervical spine through posterior approach, which has widely surgical indications. Besides, this technique is relatively safe, simple and has achieved favorable curative effect in clinic. Laminar screw fixation technique is rarely used in clinic, but the study of anatomy and biomechanics confirmed that this technique can be applied as a salvage technique in clinic. Above four techniques of the screw fixation in the lower cervical spine through posterior approach have advantages and disadvantages, respectively, and the application in clinic is different. Through the biomechanics study of these techniques will contribute to the development of the techniques of the screw fixation in the lower cervical spine through posterior approach and guide the clinical work effectively.
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J Neurosurg Spine
January 2025
1Department of Spine Surgery, Hospital for Special Surgery, New York.
Objective: When creating minimally invasive spine fusion constructs, accurate pedicle screw fixation is essential for biomechanical strength and avoiding complications arising from delicate surrounding structures. As research continues to analyze how to improve accuracy, long-term patient outcomes based on screw accuracy remain understudied. The objective of this study was to analyze long-term patient outcomes based on screw accuracy.
View Article and Find Full Text PDFEur Spine J
January 2025
Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, 45 Changchun Street, Xicheng District, Beijing, China.
Purpose: To describe a novel alternative technique for C2 fixation under the concept of atlantoaxial joint distraction and fusion with intra-articular Cages, and to report its preliminary clinical outcomes.
Methods: Eighteen patients with basilar invagination and atlantoaxial dislocation underwent atlantoaxial joint distraction and fusion with intra-articular Cages. All patients had hypoplasia of the C2 isthmus prohibiting insertion of the pedicle screw.
BMC Geriatr
January 2025
Department of Neurosurgery, Yonsei University College of Medicine, 50, Yonsei-Ro, Seodaemun-Gu, Seoul, 03722, Republic of Korea.
Background: Comparative studies of posterior lumbar interbody fusion with cortical bone trajectory and pedicle screw in older patients, particularly in those aged ≥ 80 years, are rare. This study aimed to retrospectively analyze the clinical and surgical outcomes following posterior lumbar interbody fusion with pedicle screw fixation compared to cortical bone trajectory in patients aged ≥ 80 years with degenerative lumbar spine disease.
Methods: We included 68 patients aged ≥ 80 years who underwent degenerative lumbar spinal surgery at our spine center between January 2011 and December 2020.
Med Leg J
January 2025
Department of Neurosurgery, Tufts Medical Center, Tufts University School of Medicine, Boston, USA.
Spine surgery is highly litigious; misplaced screws and intraoperative neuromonitoring frequently feature in lawsuits. Intraoperative neuromonitoring aims to prevent injury but its standards are debated, and literature suggests its benefits are mixed. We surveyed its use among neurosurgeons from the Congress of Neurological Surgeons with Pearson's chi-square test applied to analyse data within R.
View Article and Find Full Text PDFJ Spine Surg
December 2024
Surgical and Orthopaedic Research Laboratories, Prince of Wales Clinical School, University of New South Wales, Sydney, AUS.
Background: Implant fixation is often the cornerstone of musculoskeletal surgical procedures performed to provide bony fixation and/or fusion. The aim of this study was to evaluate how different design features and manufacturing methods influence implant osseointegration and mechanical properties associated with fixation in a standardized model in cancellous bone of adult sheep.
Methods: We evaluated the performance of three titanium alloy implants: (A) iFuse-TORQ implant; (B) Fenestrated Sacroiliac Device; and (C) Standard Cancellous Bone Screw in the cancellous bone of the distal femur and proximal tibia in 8 sheep.
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