{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,6,20]],"date-time":"2025-06-20T04:44:26Z","timestamp":1750394666636},"reference-count":42,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2017,4]]},"abstract":"\n Study Design:<\/jats:title>\n Cadaveric and biomechanical study.<\/jats:p>\n <\/jats:sec>\n \n Objective:<\/jats:title>\n The aim of this study was to assess the safety and pullout strength of medial, partial nonthreaded thoracic pedicle screws compared with conventional screws.<\/jats:p>\n <\/jats:sec>\n \n Summary of Background Data:<\/jats:title>\n The perforation rate of the pedicle screws has been reported as high as 41%. Nerve injury and irritation can result from the compression of malpositioned screw on neural structures.<\/jats:p>\n <\/jats:sec>\n \n Methods:<\/jats:title>\n Ten fresh cadavers were studied. Screws, 5.0 and 6.0 mm, were inserted from T1 to T6 and T7 to T12, respectively. Pedicle perforations and fractures were recorded upon screw insertion and final positioning (nonthreaded portion facing medially) after a wide laminectomy. Pullout strength of novel and conventional screws were then tested using an Instron machine in an artificial bone substitute.<\/jats:p>\n <\/jats:sec>\n \n Results:<\/jats:title>\n A total of 240 thoracic pedicle screws were inserted. Of them, 88.8% (213 screws) were fully contained during screw insertion. There were 5.0% (12 screws) grade 1 medial perforations and 6.2% (15 screws) grade 1 lateral perforations during screw insertion. Upon final positioning, 93.8% (225 screws) were fully contained. All grade 1 medial perforations, which occurred during insertion, were converted to grade 0. No dural or nerve root injuries occurred. Pedicle split fractures were noted in 6.7% (16 screws). The use of medial, partial nonthreaded screws reduced the overall perforation rate from 11.2% to 6.2%. The mean pullout load for the 5 mm fully threaded screw versus medial, partial nonthreaded was 1419.3\u00b1106.1 N (1275.8\u20131538.8 N) and 1336.6\u00b144.2 N (1293.0\u20131405.1 N) respectively, whereas 6 mm pullout load averaged 2126.0\u00b1134.8 N (1986.3\u20132338.3 N) and 2036.5\u00b1210.0 N (1818.4\u20132355.9 N). The difference was not statistically significant.<\/jats:p>\n <\/jats:sec>\n \n Conclusions:<\/jats:title>\n The use of medial, partial nonthreaded pedicle screws reduced the medial perforation rate from 5.0% to 0%; however, the pullout strength was not significantly reduced. The use of this novel screw can potentially reduce the incidence of nerve injury or irritation after medial pedicle perforations.<\/jats:p>\n <\/jats:sec>","DOI":"10.1097\/bsd.0b013e3182aab29d","type":"journal-article","created":{"date-parts":[[2013,10,1]],"date-time":"2013-10-01T07:11:41Z","timestamp":1380611501000},"page":"E297-E304","source":"Crossref","is-referenced-by-count":6,"title":["The Safety and Strength of a Novel Medial, Partial Nonthreaded Pedicle Screw"],"prefix":"10.1097","volume":"30","author":[{"given":"Mun Keong","family":"Kwan","sequence":"first","affiliation":[{"name":"Department of Orthopaedic Surgery, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chris Yin Wei","family":"Chan","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lim Beng","family":"Saw","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shanmugam","family":"Rukmanikanthan","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lawrence G.","family":"Lenke","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Washington University Medical Center, Saint Louis, MO"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","reference":[{"key":"R1-20230831","doi-asserted-by":"crossref","first-page":"7","DOI":"10.1097\/00003086-198602000-00003","article-title":"Internal fixation of the lumbar spine with pedicle screw plating","volume":"203","author":"Roy-Camille","year":"1986","journal-title":"Clin Orthop Relat Res"},{"key":"R2-20230831","doi-asserted-by":"crossref","first-page":"257","DOI":"10.1097\/01.BRS.0000106979.54651.D6","article-title":"Biomechanical evaluation of contemporary posterior spinal internal fixation configurations in an unstable burst-fracture calf spine model: special references of hook configurations and pedicle screws","volume":"29","author":"An","year":"2004","journal-title":"Spine (Phila Pa 1976)"},{"key":"R3-20230831","doi-asserted-by":"crossref","first-page":"2040","DOI":"10.1097\/01.brs.0000138268.12324.1a","article-title":"Comparative analysis of pedicle screw versus hook instrumentation in posterior spinal fusion of adolescent idiopathic scoliosis","volume":"29","author":"Kim","year":"2004","journal-title":"Spine (Phila Pa 1976)"},{"key":"R4-20230831","doi-asserted-by":"crossref","first-page":"859","DOI":"10.1097\/01.brs.0000209251.65417.16","article-title":"Combined anterior plus posterior stabilization versus posterior short-segment instrumentation and fusion for mid-lumbar (L2-L4) burst fractures","volume":"31","author":"Korovessis","year":"2006","journal-title":"Spine (Phila Pa 1976)"},{"key":"R5-20230831","doi-asserted-by":"crossref","first-page":"1157","DOI":"10.1097\/00007632-200005010-00018","article-title":"Successful short-segment instrumentation and fusion for thoracolumbar spine fractures: a consecutive 4\u00bd-year series","volume":"25","author":"Parker","year":"2000","journal-title":"Spine (Phila Pa 1976)"},{"key":"R6-20230831","doi-asserted-by":"crossref","first-page":"445","DOI":"10.1097\/00024720-200212000-00001","article-title":"The accuracy of pedicle screw placement in the thoracic spine using the \u201cFunnel Technique\u201d: part 1. 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