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Repair of Failed Transpedicle Screw Fixation: A Biomechanical Study Comparing Polymethylmethacrylate, Milled Bone, and Matchstick Bone Reconstruction

Pfeifer, Bernard A., MD; Krag, Martin H., MD; Johnson, Christopher

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In a random, controlled laboratory study, pedicle screws placed in human cadaveric vertebrae were axially loaded to failure. Three repair methods were tested. Use of low pressure polymethylmethacrylate yielded 149% of the original pullout strength, milled bone yielded 70% of the initial pullout strength, and matchstick bone yielded 56% of the initial pullout strength. Two incidents of cortical penetration during reinsertion in the matchstick group occurred. The results were statistically analyzed.

Lahey Clinic, Boston, Massachusetts, and University of Vermont Medical School, Burlington, Vermont.

© Lippincott-Raven Publishers.