Using a Combination of Intralaminar and Pedicular Screw Constructs for Enhancement of Spinal Stability and Maintenance of Correction in Patients With Sagittal Imbalance: Clinical Applications and Finite Element Analysis.

摘要: Study design Case series and finite element analysis. Objective To report the clinical results of using intralaminar screw-rod (ILS) constructs as supplements to regular pedicle screw (PS) in "high risk for implant failure" patients a analysis (FEA) this new instrumentation technique. Summary background data Despite advances surgery implantation techniques, osteoporosis, obesity, revision surgeries, neuromuscular conditions (such Parkinson disease) are challenges against achieving solid arthrodesis maintaining correction. Additional fixation strategies must be considered these patients. There is only one study literature suggesting that ILS can used alternative anchor points and/or increase strength conjunction with PSs. Materials methods Five (3 male 2 female) mechanical comorbidities underwent PS+ILS treat sagittal imbalance. In radiologic analysis, thoracic kyphosis, lumbar lordosis, vertical axis were analyzed. FEA augmentation technique carried out.Four different models created: (1) full-construct model ILS+PS levels above below osteotomy T10; (2) PS (3) 1 level osteotomy; (4) short-segment PSs osteotomy. The stress/load distributions on implants vertebrae Results mean age included was 41 years follow-up 28.2 months. A total 87 39 ILSs used. Both kyphosis angles showed significant improvements maintained at latest follow-up. No pseudarthrosis or failures observed. indicated addition construct enabled decreased load bearing increased life. Conclusions Addition an decreases line deformation reduces stress points, combination improves stability over conventional PS-rod