title: Substitution of transpedicular screws by hook claws in a vertebrectomy model.
abstract: At times one pedicle screw cannot be used in a posterior construct because of morphometric reasons or when the pedicle is fractured intraoperatively. It is not clear from the literature whether and to what extent a construct's stability is compromised by substituting a hook claw for one pedicle screw. A synthetic vertebra model using a hook claw in lieu of a pedicle screw in a compressive and torsional mechanical study is evaluated. Isola screw-based constructs varying in the number of pedicle screws and hook claws were used. To recreate a realistic clinical scenario, transverse connectors and a Harms cage were used as well. In compression, substituting screws with claws did not substantially change the stiffness, whereas substituting one or two pedicle screws with one or two hook claws significantly reduced torsional stiffness. We conclude that using one or two hook claws is a viable alternative for pedicle screws when the latter cannot be used in a clinical situation, especially as an adjunct when the anterior column is reconstructed.
authors.affiliation: Department of Orthopedic Surgery, Montefiore Medical Center, Bronx, NY 10467, USA.
authors.forename: J Y
authors.initials: JY
authors.lastname: Margulies
authors.forename: S A
authors.initials: SA
authors.lastname: Caruso
authors.forename: D
authors.initials: D
authors.lastname: Chattar-Cora
authors.forename: J M
authors.initials: JM
authors.lastname: Gorup
authors.forename: R
authors.initials: R
authors.lastname: Puri
authors.forename: S P
authors.initials: SP
authors.lastname: Thampi
authors.forename: T R
authors.initials: TR
authors.lastname: Haher
mesh_terms: D001863:Bone Screws; D019245:Compressive Strength; D006801:Humans; D007403:Intervertebral Disc / Q000502:physiology; D008159:Lumbar Vertebrae / Q000502:physiology / Q000601:surgery*; D008953:Models, Anatomic; D010969:Plastics; D013123:Spinal Fusion / Q000295:instrumentation*; D014102:Torsion Abnormality; D016474:Weight-Bearing
chemical_list: D010969:Plastics