THE EFFECT OF PARTIAL FACETECTOMY VS. NO FACETECTOMY ON VERTEBRAL PURCHASE OF COLORADO-2 PEDICLE HOOK
Journal Title: Journal of Turkish Spinal Surgery - Year 2005, Vol 16, Issue 1
Abstract
INTRODUCTION: Partial facetectomy can improve the seating of the hook on the pedicle by different ways. The recommended pedicle hook placement in Colorado-2 system is without facetectomy. There is no biomechanical study in the literature comparing the strength of hook/laminar interface between the partial facetectomy an~ no facetectomy in the Colorado-2 pedicle hook (C2PH) design against 45 degrees posterolateral pull-out force. MATERIAL&METHODS: T4, T5, T8 and T9 levels of 5 fresh frozen human cadavers were instrumented with C2PH. Half of the implant sites were undergone to facetectomy. The potted specimens, embedded in U shaped metal profile filled by PMMA, were mounted with a 45 degrees of angle to the lower platform of MTS Mini Bionix Model Machine and a pull-out force 45 degrees posterolateral to the specimen was applied by the upper arm of the MTS machine. The lower platform was blocked and the upper arm permitted only for hinge movement between the rod and instrument during the posterolateral pull-outs. RESULTS: All of the no facetectomy cases (100%) showed gap between pedicle and the hook and medialization in the x-rays. Half (%50) of the facetectomy cases showed ideal seating while the others (%50) showed some medialization or gap. The failure forces and failure patterns of no facetectomy (609N) and facetectomy (636N) groups were quite similar. But a trend of difference appeared when the ideally seated facetectomy group (778N) compared with the other cases (493N) of this group (p<0.1). CONCLUSION: Facetectomy can reduce the strength of the lamina in cases which the, hook does not seat ideally. This effect probably due to destruction of the integrity of the lamina and facetectomy can become a risky procedure if the hook misses the pedicle. But facetectomy can facilitate the ideal seat of the pedicle hook onto the pedicle in Colorado-2 pedicular hooks and contribute more strength even without using any additional tools.
Authors and Affiliations
NAZ‹R C‹HANG‹R ‹SLAM (Haydarpaßa Numune Hospital, Turkey), THOMAS STEFFEN, ENSORE TRANSFELDT, JAMES D SCHWENDER, LARA COHEN
Keywords
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