The Mechanisms of Medial Pedicle Wall Violation: Insertion Method Is as Important as Correct Cannulation of the Pedicle
A cadaver study aims to determine the mechanisms of medial pedicle wall violation after a correct cannulation of the pedicle. The study presents finding out the effect of insertion angle and insertion force on medial wall violation. We used 100 lumbar pedicles of cadavers. Special wooden blocks were...
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| Format: | Article |
| Language: | English |
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Wiley
2014-01-01
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| Series: | Advances in Orthopedics |
| Online Access: | http://dx.doi.org/10.1155/2014/283783 |
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| _version_ | 1832563178048847872 |
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| author | Cengiz Isik Kamil Cagri Kose Mustafa Erkan Inanmaz Suleyman Murat Tagil Hakan Sarman |
| author_facet | Cengiz Isik Kamil Cagri Kose Mustafa Erkan Inanmaz Suleyman Murat Tagil Hakan Sarman |
| author_sort | Cengiz Isik |
| collection | DOAJ |
| description | A cadaver study aims to determine the mechanisms of medial pedicle wall violation after a correct cannulation of the pedicle. The study presents finding out the effect of insertion angle and insertion force on medial wall violation. We used 100 lumbar pedicles of cadavers. Special wooden blocks were produced to simulate a fixed angle fault after a correct pedicle cannulation. Pedicles were divided into 4 groups: 10-degree free drive (group 10), 15-degree free drive (group 15), 10-degree push drive (group 10P), and 15-degree push drive (group 15P). After insertion of pedicle screws, laminectomies were done and the pedicles were evaluated from the inside. Pedicle complications were more in group 10P than group 10 (P=0.009). Medial wall fracture (P=0.002) and canal penetration were more in group 15P than group 15 (P=0.001). Groups 10P and 15P were similar regarding medial wall fractures but canal penetration was significantly higher in group 15P (P=0.001). Medial wall breaches can happen after correct cannulation of pedicles. Change in insertion angle is one factor but the most important factor is the use of a pushing force while inserting a screw. The pedicle seems to be extremely tolerant to insertion angulation mistakes up to 10 degrees and tends to lead the screw into the correct path spontaneously. |
| format | Article |
| id | doaj-art-c7ed8a975d1b47b6a6a6d8035cd33a01 |
| institution | Kabale University |
| issn | 2090-3464 2090-3472 |
| language | English |
| publishDate | 2014-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Advances in Orthopedics |
| spelling | doaj-art-c7ed8a975d1b47b6a6a6d8035cd33a012025-02-03T01:20:53ZengWileyAdvances in Orthopedics2090-34642090-34722014-01-01201410.1155/2014/283783283783The Mechanisms of Medial Pedicle Wall Violation: Insertion Method Is as Important as Correct Cannulation of the PedicleCengiz Isik0Kamil Cagri Kose1Mustafa Erkan Inanmaz2Suleyman Murat Tagil3Hakan Sarman4Department of Orthopedics and Traumatology, Abant Izzet Baysal University Medical School, Golkoy, 14280 Bolu, TurkeyDepartment of Orthopedics and Traumatology, Marmara University Medical School, Istanbul, TurkeyDepartment of Orthopedics and Traumatology, Sakarya University Medical School, Sakarya, TurkeyDepartment of Anatomy, Turgut Özal University, Medical School, Ankara, TurkeyDepartment of Orthopedics and Traumatology, Abant Izzet Baysal University Medical School, Golkoy, 14280 Bolu, TurkeyA cadaver study aims to determine the mechanisms of medial pedicle wall violation after a correct cannulation of the pedicle. The study presents finding out the effect of insertion angle and insertion force on medial wall violation. We used 100 lumbar pedicles of cadavers. Special wooden blocks were produced to simulate a fixed angle fault after a correct pedicle cannulation. Pedicles were divided into 4 groups: 10-degree free drive (group 10), 15-degree free drive (group 15), 10-degree push drive (group 10P), and 15-degree push drive (group 15P). After insertion of pedicle screws, laminectomies were done and the pedicles were evaluated from the inside. Pedicle complications were more in group 10P than group 10 (P=0.009). Medial wall fracture (P=0.002) and canal penetration were more in group 15P than group 15 (P=0.001). Groups 10P and 15P were similar regarding medial wall fractures but canal penetration was significantly higher in group 15P (P=0.001). Medial wall breaches can happen after correct cannulation of pedicles. Change in insertion angle is one factor but the most important factor is the use of a pushing force while inserting a screw. The pedicle seems to be extremely tolerant to insertion angulation mistakes up to 10 degrees and tends to lead the screw into the correct path spontaneously.http://dx.doi.org/10.1155/2014/283783 |
| spellingShingle | Cengiz Isik Kamil Cagri Kose Mustafa Erkan Inanmaz Suleyman Murat Tagil Hakan Sarman The Mechanisms of Medial Pedicle Wall Violation: Insertion Method Is as Important as Correct Cannulation of the Pedicle Advances in Orthopedics |
| title | The Mechanisms of Medial Pedicle Wall Violation: Insertion Method Is as Important as Correct Cannulation of the Pedicle |
| title_full | The Mechanisms of Medial Pedicle Wall Violation: Insertion Method Is as Important as Correct Cannulation of the Pedicle |
| title_fullStr | The Mechanisms of Medial Pedicle Wall Violation: Insertion Method Is as Important as Correct Cannulation of the Pedicle |
| title_full_unstemmed | The Mechanisms of Medial Pedicle Wall Violation: Insertion Method Is as Important as Correct Cannulation of the Pedicle |
| title_short | The Mechanisms of Medial Pedicle Wall Violation: Insertion Method Is as Important as Correct Cannulation of the Pedicle |
| title_sort | mechanisms of medial pedicle wall violation insertion method is as important as correct cannulation of the pedicle |
| url | http://dx.doi.org/10.1155/2014/283783 |
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