Distractional failure forces comparison of different anchor sites for the pediatric growing rod technique.

Eur Spine J

Guangdong Provincial Key Laboratory of Medical Biomechanics, Department of Anatomy, School of Basic Medicine Science, Southern Medical University, No. 1838, Guangzhou Avenue North, Guangzhou, 510515, Guangdong, China.

Published: June 2014

Purpose: To analyze the distraction load-to-failure force supported by pedicle, lamina or rib linked to different constructs in pediatric cadaveric thoracic spine.

Methods: Eighteen pediatric cadaveric thoracic spines with rib cages were randomly assigned into three testing groups: A (lamina and pedicle), B (rib and pedicle), and C (rib and lamina). Each specimen was sectioned into six units from T1-T2 to T11-T12. A longitudinal load-to-failure test simulating growing rod distraction force was performed with an ElectroForce(®)3500 machine, and yield forces were statistically analyzed.

Results: The results showed that pedicle and lamina anchors could provide a similar capacity against distraction force in group A (P > 0.05), which was almost double that of ribs in groups B and C (P < 0.05). The data showed that T5 and T7 pedicles and laminas seem to provide the lowest distractional force. Furthermore, break pedicle insertion provides 75.6 % of distractional force as compared to the same segments with intact pedicle insertion.

Conclusions: Our results suggest the lamina as a proximal thoracic anchor site for pediatric spinal deformity. The pedicle and lamina of T5 and T7 vertebrae seemed to provide a lower distractional force than other thoracic segments in our test.

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Source
http://dx.doi.org/10.1007/s00586-014-3222-1DOI Listing

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