Is a cross-connector beneficial for single level traditional or cortical bone trajectory pedicle screw instrumentation?

The cortical bone trajectory (CBT) has been introduced with the aim of better screw hold, however, screw-rod constructs with this trajectory might provide less rigidity in lateral bending (LB) and axial rotation (AR) compared to the constructs with the traditional trajectory (TT). Therefore, the add...

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Autores principales:	Frédéric Cornaz, Jonas Widmer, Marie-Rosa Fasser, Jess Gerrit Snedeker, Keitaro Matsukawa, José Miguel Spirig, Mazda Farshad
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/8619a3a33c9b462bb62c49d6627d799e
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id	oai:doaj.org-article:8619a3a33c9b462bb62c49d6627d799e
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spelling	oai:doaj.org-article:8619a3a33c9b462bb62c49d6627d799e2021-12-02T20:10:43ZIs a cross-connector beneficial for single level traditional or cortical bone trajectory pedicle screw instrumentation?1932-620310.1371/journal.pone.0253076https://doaj.org/article/8619a3a33c9b462bb62c49d6627d799e2021-01-01T00:00:00Zhttps://doi.org/10.1371/journal.pone.0253076https://doaj.org/toc/1932-6203The cortical bone trajectory (CBT) has been introduced with the aim of better screw hold, however, screw-rod constructs with this trajectory might provide less rigidity in lateral bending (LB) and axial rotation (AR) compared to the constructs with the traditional trajectory (TT). Therefore, the addition of a horizontal cross-connector could be beneficial in counteracting this possible inferiority. The aim of this study was to compare the primary rigidity of TT with CBT screw-rod constructs and to quantify the effect of cross-connector-augmentation in both. Spines of four human cadavers (T9 -L5) were cropped into 15 functional spine units (FSU). Eight FSUs were instrumented with TT and seven FSUs with CBT pedicle screws. The segments were tested in six loading directions in three configurations: uninstrumented, instrumented with and without cross-connector. The motion between the cranial and caudal vertebra was recorded. The range of motion (ROM) between the CBT and the TT group did not differ significantly in either configuration. Cross-connector -augmentation did reduce the ROM in AR (16.3%, 0.27°, p = 0.02), LB (2.9%, 0.07°, p = 0.03) and flexion-extension FE (2.3%, 0.04°, p = 0.02) for the TT group and in AR (20.6%, 0.31°, p = 0.01) for the CBT-group. The primary rigidity of TT and CBT single level screw-rod constructs did not show significant difference. The minimal reduction of ROM due to cross-connector-augmentation seems clinically not relevant. Based on the findings of these study there is no increased necessity to use a cross-connector in a CBT-construct.Frédéric CornazJonas WidmerMarie-Rosa FasserJess Gerrit SnedekerKeitaro MatsukawaJosé Miguel SpirigMazda FarshadPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 16, Iss 6, p e0253076 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Frédéric Cornaz Jonas Widmer Marie-Rosa Fasser Jess Gerrit Snedeker Keitaro Matsukawa José Miguel Spirig Mazda Farshad Is a cross-connector beneficial for single level traditional or cortical bone trajectory pedicle screw instrumentation?
description	The cortical bone trajectory (CBT) has been introduced with the aim of better screw hold, however, screw-rod constructs with this trajectory might provide less rigidity in lateral bending (LB) and axial rotation (AR) compared to the constructs with the traditional trajectory (TT). Therefore, the addition of a horizontal cross-connector could be beneficial in counteracting this possible inferiority. The aim of this study was to compare the primary rigidity of TT with CBT screw-rod constructs and to quantify the effect of cross-connector-augmentation in both. Spines of four human cadavers (T9 -L5) were cropped into 15 functional spine units (FSU). Eight FSUs were instrumented with TT and seven FSUs with CBT pedicle screws. The segments were tested in six loading directions in three configurations: uninstrumented, instrumented with and without cross-connector. The motion between the cranial and caudal vertebra was recorded. The range of motion (ROM) between the CBT and the TT group did not differ significantly in either configuration. Cross-connector -augmentation did reduce the ROM in AR (16.3%, 0.27°, p = 0.02), LB (2.9%, 0.07°, p = 0.03) and flexion-extension FE (2.3%, 0.04°, p = 0.02) for the TT group and in AR (20.6%, 0.31°, p = 0.01) for the CBT-group. The primary rigidity of TT and CBT single level screw-rod constructs did not show significant difference. The minimal reduction of ROM due to cross-connector-augmentation seems clinically not relevant. Based on the findings of these study there is no increased necessity to use a cross-connector in a CBT-construct.
format	article
author	Frédéric Cornaz Jonas Widmer Marie-Rosa Fasser Jess Gerrit Snedeker Keitaro Matsukawa José Miguel Spirig Mazda Farshad
author_facet	Frédéric Cornaz Jonas Widmer Marie-Rosa Fasser Jess Gerrit Snedeker Keitaro Matsukawa José Miguel Spirig Mazda Farshad
author_sort	Frédéric Cornaz
title	Is a cross-connector beneficial for single level traditional or cortical bone trajectory pedicle screw instrumentation?
title_short	Is a cross-connector beneficial for single level traditional or cortical bone trajectory pedicle screw instrumentation?
title_full	Is a cross-connector beneficial for single level traditional or cortical bone trajectory pedicle screw instrumentation?
title_fullStr	Is a cross-connector beneficial for single level traditional or cortical bone trajectory pedicle screw instrumentation?
title_full_unstemmed	Is a cross-connector beneficial for single level traditional or cortical bone trajectory pedicle screw instrumentation?
title_sort	is a cross-connector beneficial for single level traditional or cortical bone trajectory pedicle screw instrumentation?
publisher	Public Library of Science (PLoS)
publishDate	2021
url	https://doaj.org/article/8619a3a33c9b462bb62c49d6627d799e
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Is a cross-connector beneficial for single level traditional or cortical bone trajectory pedicle screw instrumentation?

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