Transdiscal Screw Fixation in L5-S1 Spondylolysis: a Biomechanical Study Transdiscal Screw Fixation in L5-51 Spondylolysis

Abstract

Aim: This study aimed to investigate whether the L5-S1 transdiscal screw fixation is biomechanically sufficient against axial loads and the resulting shear forces. Material and Methods: Eighteen fresh calf spines under 1 year of age were used in this study. Two randomly selected spines were used as test materials. The inferior facet and ligamentum flavum were removed in 7 randomly selected spines. In these spines (transdiscal screw group), two transdiscal screws were placed bilaterally between 15 and S1. Tests were performed on the remaining 9 spines, while the spines were initially intact (intact group) and after creating a listhesis model (injury group). The extent of displacement occurring as a result of axial loading was noted in all groups in order to calculate the load-displacement curves.

Results: The mean displacement as a result of successive axial loadings of 5000 N was as follows: 3 mm (range: 2.4 - 4 mm) in the intact group, 3.5 mm (range: 3 - 4.5 mm) in the transdiscal screw group and 4.5 mm (range: 3.9 - 5 mm) In the group with injury. The difference was statistically significant (p<0.05). None of the samples exhibited broken screws, screw deformation or dislocation, even in failure tests, in the transdiscal screw group. Discussion: These findings have shown that transdiscal screw fixation can be biomechanically sufficient against the shear forces occurring as a result of axial loading. We believe that this technique can be a good alternative as a fixation method for the L5-S1 spondylolisthesis.