mersin univ saglık bilim derg

Mersin Üniversitesi Sağlık Bilimleri Dergisi

1308-0830

Mersin University

10.26559/mersinsbd.605225

Health Care Administration

Sağlık Kurumları Yönetimi

Konik ve silindirik pedikül vidalarının sıyırma dirençleri ve direngenliklerinin karşılaştırmalı biyomekanik analizi

A comparative biomechanical analysis of pull-out resistance and stiffness of conical and cylindrical pedicle screws

https://orcid.org/0000-0003-4521-4312

Polat

Ömer

DÜZCE ÜNİVERSİTESİ, TIP FAKÜLTESİ, TIP PR.

https://orcid.org/0000-0003-2157-7477

Gezici

Ali Rıza

BOLU ABANT İZZET BAYSAL ÜNİVERSİTESİ, TIP FAKÜLTESİ

https://orcid.org/0000-0002-3845-2665

Uçkun

Özhan Merzuk

ANKARA NUMUNE SAĞLIK UYGULAMA VE ARAŞTIRMA MERKEZİ

https://orcid.org/0000-0002-1503-1016

Nacar

Osman Arıkan

YÜKSEK İHTİSAS ÜNİVERSİTESİ

12 31 2019

12 3 367 377 08 13 2019 09 18 2019

2008

Mersin Üniversitesi Sağlık Bilimleri Dergisi

Amaç: Transpediküler enstrümantasyonda konikve silindirik pedikül vidaları sık kullanılmaktadır. Vidaların mekanikperformansı kemik-vida yüzeyinin biyomekanik özellikleri ve vidanın fizikselyapısı ile ilişkilidir. Bu çalışmada, konik ve silindirik pedikül vidalarınınbiyomekanik açıdan farklarının olup olmadığının araştırılması amaçlandı. Yöntem: İskelet maturasyonunutamamlamış, 400-600 kg ağırlığında 24–32 haftalık danalardan elde edilmiş taze lombervertebralar kullanıldı. Toplam 24vertebranın her iki pedikülüne (48 pedikül) vida yerleştirilerek biyomekaniktestler uygulandı. Vidaların maksimum giriş tork değerleri analog tork metre kullanılarakkaydedildi. Rijidtespitin sağlanması için polimetilmetakrilat içeren metal kutuların içerisinegömülü vertebradaki pedikül vidaları mekanik test makinasına bağlanarak sıyırmadirenci ölçüldü. Bulgular: Konikvidaların sıyırma dirençlerinin ve direngenliklerinin ilk atım ve tekrarlayanatımlarda silindirik vidalara göre yüksek olduğu, ancak aradaki farkınistatistiksel olarak anlamlı olmadığı tespit edildi (p>0.05). Maksimum giriştork değeri ise konik vidalarda silindirik vidalara göre istatistiksel olarakanlamlı düzeyde yüksek idi (p=0.04). Vidaların 180º ve 360°geri çekimli sıyırmadirenci ve direngenlik verileri arasında istatistiksel olarak anlamlı farkolmadığı tespit edildi (p>0.05). Sonuç:Konik vidaların silindirik vidalara göre daha dirençli tutunma verilerinesahip olmalarının yanı sıra, aynı delikten yapılan çoklu vida atımlarında ya dageri çekilme işlemi sonucunda vidalar arasında sıyrılma verileri açısındanbelirgin bir fark izlenmemiş olması, konik vidaların gelecekte daha sıkkullanılacaklarını düşündürmektedir.

Aim:Conical and cylindrical pedicle screws are frequently usedin transpedicular instrumentation. The mechanical performance of screws isassociated with the biomechanical properties of the bone–screw surface and thephysical structure of the screw. The purpose of this study was to investigatewhether conical and cylindrical pedicle screws differ in their biomechanicalproperties. Methods: Fresh lumbarvertebrae were obtained from 24–32-week-old calves that completed skeletalmaturation and weighed 400–600 kg. Screws were placed on both pedicles (48pedicles) of total 24 vertebrae, and biomechanical tests were performed. Themaximum input torque values of the screws were recorded using an analog torquemeter. Pull-out resistance was measured by attaching pedicle screws in thevertebra. The vertebral pedicle screws were embedded into metal boxescontaining polymethyl-methacrylate to provide rigid fixation to a mechanicaltester. Results: Pull-out resistanceand stiffness were higher in conical screws than in cylindrical screws in thefirst and repetitive insertions; however, the difference was not statisticallysignificant (p>0.05). The maximum input torque was significantly higher(p=0.04) in conical screws than in cylindrical screws. No significantdifference (p>0.05) was observed between pull-out resistance and stiffnessvalues of the screws with 180° and 360° back-outs. Conclusion: Conical screws had more resistant fixation data thancylindrical screws, and there was no significant difference between the screwsin terms of pull-out resistance data due to multiple screw insertions performedfrom the same hole or due to the back-out procedure; this indicates thatconical screws are likely be used more frequently in the future.

Transpediküler fiksasyon Konik vida Silindirik vida Biyomekanin analiz

Transpedicular fixation conical screw cylindrical screw biomechanical analysis

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