The biomechanics of pedicle screw-based instrumentation

W. Cho, S. K. Cho, C. Wu

Research output: Contribution to journalReview articlepeer-review

186 Scopus citations


There are three basic concepts that are important to the biomechanics of pedicle screw-based instrumentation. First, the outer diameter of the screw determines pullout strength, while the inner diameter determines fatigue strength. Secondly, when inserting a pedicle screw, the dorsal cortex of the spine should not be violated and the screws on each side should converge and be of good length. Thirdly, fixation can be augmented in cases of severe osteoporosis or revision. A trajectory parallel or caudal to the superior endplate can minimise breakage of the screw from repeated axial loading. Straight insertion of the pedicle screw in the mid-sagittal plane provides the strongest stability. Rotational stability can be improved by adding transverse connectors. The indications for their use include anterior column instability, and the correction of rotational deformity.

Original languageEnglish (US)
Pages (from-to)1061-1065
Number of pages5
JournalJournal of Bone and Joint Surgery - Series B
Issue number8
StatePublished - Aug 2010
Externally publishedYes

ASJC Scopus subject areas

  • Surgery
  • Orthopedics and Sports Medicine


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