title: Biomechanical comparison of translaminar screw versus pedicle screw supplementation of anterior femoral ring allografts in one-level lumbar spine fusion.
abstract: Pedicle screws (PS) can provide initial stabilization of anterior interbody femoral ring allograft (FRA) lumbar constructs. Translaminar screws (TLS) have also been advocated for this procedure. The objective of this study was to use an in vitro human cadaveric model to compare the stability of one-level anterior interbody lumbar constructs stabilized with PS and those stabilized with TLS. Five human cadaveric spinal motion segments (L4-S2) were biomechanically evaluated in the intact condition and using the follow- ing methods of stabilization: anterior interbody fusion with FRA, anterior FRA supplemented with PS, and anterior FRA supplemented with TLS. Stability was determined for each construct by measuring construct displacement as a function of applied load under the following conditions: compression, flexion, extension, lateral bending to each side, and axial torsion. There were no statistically significant differences in construct stability between FRA supplemented with PS and FRA supplemented with TLS under any of the loading conditions. In selected cases, supplementation of anterior femoral ring allograft with translaminar screws is a viable alternative to supplementation with pedicle screws.
authors.affiliation: Department of Orthopaedic Surgery, NYU Hospital for Joint Diseases, New York, New York, USA. afshin.razi@nyumc.org
authors.forename: Afshin E
authors.initials: AE
authors.lastname: Razi
authors.forename: Jeffrey M
authors.initials: JM
authors.lastname: Spivak
authors.forename: Frederick J
authors.initials: FJ
authors.lastname: Kummer
authors.forename: David S
authors.initials: DS
authors.lastname: Hersh
authors.forename: Jeffrey A
authors.initials: JA
authors.lastname: Goldstein
mesh_terms: D001696:Biomechanical Phenomena; D001863:Bone Screws; D016025:Bone Transplantation / Q000009:adverse effects; D002102:Cadaver; D005269:Femur / Q000637:transplantation*; D006801:Humans; D066298:In Vitro Techniques; D007593:Joint Instability / Q000209:etiology / Q000503:physiopathology; D008159:Lumbar Vertebrae / Q000503:physiopathology / Q000601:surgery*; D016059:Range of Motion, Articular; D013123:Spinal Fusion / Q000009:adverse effects / Q000295:instrumentation*; D014184:Transplantation, Homologous