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Article: Biomechanical effects of the extent of sacrectomy on the stability of lumbo-iliac reconstruction using iliac screw techniques: What level of sacrectomy requires the bilateral dual iliac screw technique?

TitleBiomechanical effects of the extent of sacrectomy on the stability of lumbo-iliac reconstruction using iliac screw techniques: What level of sacrectomy requires the bilateral dual iliac screw technique?
Authors
KeywordsBiomechanics
Iliac screw
Lumbo-iliac fixation
Sacral tumor
Sacrectomy
Issue Date2010
PublisherPergamon. The Journal's web site is located at http://www.elsevier.com/locate/clinbiomech
Citation
Clinical Biomechanics, 2010, v. 25 n. 9, p. 867-872 How to Cite?
AbstractBackground: Although both single and dual iliac screw techniques are used in spino-pelvic reconstruction following sacrectomy for treating sacral tumors, the basis for choosing between the two techniques for different instability types remains undetermined. The purpose of this study was to evaluate the effects of the extent of sacrectomy on the stability of the lumbo-iliac fixation construct using single and dual iliac screw techniques. Methods: Nine human L2-pelvic specimens were tested for their intact condition simulated by L3-L5 pedicle screw fixation. Sequential partial sacrectomies and L3-iliac fixation using bilateral single and dual iliac screws were conducted on the same specimens as follows: under-S1 sacrectomy + single screw, under-1/2S1 sacrectomy + single screw, one-side sacroiliac joint resection + single screw, total sacrectomy + single screw, and total sacrectomy + dual screw. Biomechanical testing was performed on a material testing machine for evaluating the stiffness of the L3-iliac fixation construct in compression and torsion. Findings: Single iliac screw technique was found to effectively restore the local stability in under-1/2S1 sacrectomy. However, it could not provide adequate stability for further resection of one-side sacroiliac joint in torsion and total sacrectomy in compression (P < 0.05). On the other hand, dual iliac screw technique could restore the stability to the intact condition after total sacrectomy in both compression and torsion. Interpretation: The single iliac screw technique for L3-iliac fixation could effectively restore the local stability for under-1/2S1 sacrectomy. However, for instabilities of the under-1/2S1 sacrectomy with one-side sacroiliac joint resection or total sacrectomy, the dual iliac screw technique should be considered. © 2010 Elsevier Ltd. All rights reserved.
Persistent Identifierhttp://hdl.handle.net/10722/142442
ISSN
2015 Impact Factor: 1.636
2015 SCImago Journal Rankings: 0.982
ISI Accession Number ID
Funding AgencyGrant Number
Guangdong Provincial Medical Research Foundation of ChinaA2008161
2008B050100012
Funding Information:

The authors would like to thank Medtronic-WeiGao Inc. for providing the posterior spinal fixation system. This study was supported by Guangdong Provincial Medical Research Foundation of China (A2008161 and 2008B050100012).

References

 

DC FieldValueLanguage
dc.contributor.authorYu, BSen_HK
dc.contributor.authorZhuang, XMen_HK
dc.contributor.authorLi, ZMen_HK
dc.contributor.authorZheng, ZMen_HK
dc.contributor.authorZhou, ZYen_HK
dc.contributor.authorZou, XNen_HK
dc.contributor.authorLu, WWen_HK
dc.date.accessioned2011-10-28T02:46:06Z-
dc.date.available2011-10-28T02:46:06Z-
dc.date.issued2010en_HK
dc.identifier.citationClinical Biomechanics, 2010, v. 25 n. 9, p. 867-872en_HK
dc.identifier.issn0268-0033en_HK
dc.identifier.urihttp://hdl.handle.net/10722/142442-
dc.description.abstractBackground: Although both single and dual iliac screw techniques are used in spino-pelvic reconstruction following sacrectomy for treating sacral tumors, the basis for choosing between the two techniques for different instability types remains undetermined. The purpose of this study was to evaluate the effects of the extent of sacrectomy on the stability of the lumbo-iliac fixation construct using single and dual iliac screw techniques. Methods: Nine human L2-pelvic specimens were tested for their intact condition simulated by L3-L5 pedicle screw fixation. Sequential partial sacrectomies and L3-iliac fixation using bilateral single and dual iliac screws were conducted on the same specimens as follows: under-S1 sacrectomy + single screw, under-1/2S1 sacrectomy + single screw, one-side sacroiliac joint resection + single screw, total sacrectomy + single screw, and total sacrectomy + dual screw. Biomechanical testing was performed on a material testing machine for evaluating the stiffness of the L3-iliac fixation construct in compression and torsion. Findings: Single iliac screw technique was found to effectively restore the local stability in under-1/2S1 sacrectomy. However, it could not provide adequate stability for further resection of one-side sacroiliac joint in torsion and total sacrectomy in compression (P < 0.05). On the other hand, dual iliac screw technique could restore the stability to the intact condition after total sacrectomy in both compression and torsion. Interpretation: The single iliac screw technique for L3-iliac fixation could effectively restore the local stability for under-1/2S1 sacrectomy. However, for instabilities of the under-1/2S1 sacrectomy with one-side sacroiliac joint resection or total sacrectomy, the dual iliac screw technique should be considered. © 2010 Elsevier Ltd. All rights reserved.en_HK
dc.languageengen_US
dc.publisherPergamon. The Journal's web site is located at http://www.elsevier.com/locate/clinbiomechen_HK
dc.relation.ispartofClinical Biomechanicsen_HK
dc.subjectBiomechanicsen_HK
dc.subjectIliac screwen_HK
dc.subjectLumbo-iliac fixationen_HK
dc.subjectSacral tumoren_HK
dc.subjectSacrectomyen_HK
dc.subject.meshBone Screws-
dc.subject.meshIlium - surgery-
dc.subject.meshInternal Fixators-
dc.subject.meshSpinal Fusion - methods-
dc.subject.meshLumbar Vertebrae/surgery-
dc.titleBiomechanical effects of the extent of sacrectomy on the stability of lumbo-iliac reconstruction using iliac screw techniques: What level of sacrectomy requires the bilateral dual iliac screw technique?en_HK
dc.typeArticleen_HK
dc.identifier.emailLu, WW:wwlu@hku.hken_HK
dc.identifier.authorityLu, WW=rp00411en_HK
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.doi10.1016/j.clinbiomech.2010.06.012en_HK
dc.identifier.pmid20655639-
dc.identifier.scopuseid_2-s2.0-77957347505en_HK
dc.identifier.hkuros197073en_US
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-77957347505&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume25en_HK
dc.identifier.issue9en_HK
dc.identifier.spage867en_HK
dc.identifier.epage872en_HK
dc.identifier.isiWOS:000283899200003-
dc.publisher.placeUnited Kingdomen_HK
dc.identifier.scopusauthoridYu, BS=25633299000en_HK
dc.identifier.scopusauthoridZhuang, XM=35436325900en_HK
dc.identifier.scopusauthoridLi, ZM=36168413000en_HK
dc.identifier.scopusauthoridZheng, ZM=7403007434en_HK
dc.identifier.scopusauthoridZhou, ZY=36906256700en_HK
dc.identifier.scopusauthoridZou, XN=7203047881en_HK
dc.identifier.scopusauthoridLu, WW=7404215221en_HK
dc.identifier.citeulike7616020-

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