Possible Usage of Cannulated Pedicle Screws without Cement Augmentation

Background: The use of pedicle screws is becoming increasingly popular for spinal surgery practice as the technology advances. Screw pullout due to bone quality and loading conditions is one of the most common problems observed after pedicle screw fixation. Several solutions were studied to prevent screw pullout. These can be investigated under three main categories: screw design, expandable screws and cement augmentation. Objective: This study aimed to investigate the pullout performance of cannulated screws without cement augmentation on synthetic foams. Methods: Artificial fusion process for PU is described and validated in our previous studies. For this study six newly designed cannulated pedicle screws were artificially fused to PU foam and pullout test were conducted according to ASTM F543 standard testing protocols. Results: According to the results of post-fusion pullout tests, worst performed cannulated screw design was S3H on healthy bone simulating PU foam. However, pullout strength of unilaterally three holes including (S3H) design was purchased with two times higher loads when compared to control group. Solid cored screws were purchased with 671 N where this value was 1450 N for S3H design. Conclusions: This study provided that using cannulated pedicle screws without cement augmentation for the cases with healthy bone can be a reliable alternative to classical screws. To the knowledge of the authors this is the first post-fusion study investigating cannulated pedicle screws without cement augmentation.