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A PEDICLE SCREW MODIFICATION FOR THE HARTSHILL SYSTEM : BIOMECHANICAL AND CLINICAL RESULTS

  • N. W. Valentine
  • A. Rahmatalla
  • J. Dove

J Turk Spinal Surg 1990;1(4):169-171

The Ilartshill Rectangle with sublaminar wiring has become widely accepted in the management of a variety of spinal disorders. However, in certain circumstances in the lumbar spine, in particular in the presence of a spondylolysis or previous wide laminectomies, pedicle fixation undoubtedly has much to offer. We therefore designed a bridge device to link a rectangle to pedicle scerews. Thorough mechanical testing has been carried out. These test have shown that the pedicle screw system is mechanically satisfactory and has superior stiffness compared to the standard kwired rectangle.

A prospective trial of all patients in whom the device was implanted was carried out. We have implanted 64 bridges in 50 patients, the longest for two years. The early results are excellent, with only one mechanical failure to date. 'There have been no serious clinical complications. 'The major advantages of the system to be ease of use, reliability, increased security of fixation in difficult cases, and the ability to minimize the number of levels fused, which is particularly important in the lumbar spine.

Keywords: Back pain, sublaminar wires, pedicle screws.