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Screw Insertional Torque Measurement in Spine Surgery: Correlation With Bone Mineral Density and Hounsfield Unit – Lumbar Fusion

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The article published in Neurospine explores the technical feasibility of measuring the insertional torque of pedicle screws during spine surgery and its relationship with bone density. The study conducted on 53 patients shows that the insertional torque of screw fixation is positively correlated with bone mineral density (BMD) and Hounsfield units (HU) in the vertebrae. However, in cases of osteopenia, the correlation is weak, and in patients with osteoporosis, HU measurements show greater clinical significance compared to BMD values. The findings suggest that measuring insertional torque can be a useful indicator of screw fixation strength and bone health in spine surgery

Summarised by Mr Mo Akmal – Lead Spinal Surgeon
The London Spine Unit : most advanced day surgery unit on Harley Street UK

Published article

: The insertional torque of screw fixation significantly correlated with bone density (BMD and HU). HU measurements showed greater clinical significance than did BMD values in patients with osteoporosis.

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Neurospine. 2023 Dec;20(4):1177-1185. doi: 10.14245/ns.2346830.415. Epub 2023 Dec 31.ABSTRACTOBJECTIVE: Achieving successful fusion during spine surgery is dependent on rigid pedicle screw fixation. To assess fixation strength, the insertional torque can be measured during intraoperative screw fixation. This study aimed to explore the technical feasibility of measuring the insertional torque of a pedicle screw, while investigating,

Neurospine. 2023 Dec;20(4):1177-1185. doi: 10.14245/ns.2346830.415. Epub 2023 Dec 31.

ABSTRACT

OBJECTIVE: Achieving successful fusion during spine surgery is dependent on rigid pedicle screw fixation. To assess fixation strength, the insertional torque can be measured during intraoperative screw fixation. This study aimed to explore the technical feasibility of measuring the insertional torque of a pedicle screw, while investigating its relationship with bone density.

METHODS: Thoraco-lumbar screw fixation fusion surgery was performed on 53 patients (mean age, 65.5 ± 9.8 years). The insertional torque of 284 screws was measured at the point passing through the pedicle using a calibrated torque wrench, with a specially designed connector to the spine screw system. The Hounsfield units (HU) value was determined by assessing the trabecular portion of the index vertebral body on sagittal computed tomography images. We analyzed the relationship between the measured insertional torque and the following bone strength parameters: bone mineral density (BMD) and HU of the vertebral body.

RESULTS: The mean insertion torque was 105.55 ± 58.08 N∙cm and T-score value (BMD) was -1.14 ± 1.49. Mean HU value was 136.37 ± 57.59. Screw insertion torque was positively correlated with BMD and HU in whole patients. However, in cases of osteopenia, all variables showed very weak correlations with insertional torque. In patients with osteoporosis, there was no statistically significant correlation between BMD and torque strength; HU showed a significant correlation.

: The insertional torque of screw fixation significantly correlated with bone density (BMD and HU). HU measurements showed greater clinical significance than did BMD values in patients with osteoporosis.

PMID:38368907 | DOI:10.14245/ns.2346830.415

The London Spine Unit : most advanced day surgery unit on Harley Street UK

Read the original publication:

Screw Insertional Torque Measurement in Spine Surgery: Correlation With Bone Mineral Density and Hounsfield Unit

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Neurospine. 2023 Dec;20(4):1177-1185. doi: 10.14245/ns.2346830.415. Epub 2023 Dec 31.ABSTRACTOBJECTIVE: Achieving successful fusion during spine surgery is dependent on rigid pedicle screw fixation. To assess fixation strength, the insertional torque can be measured during intraoperative screw fixation. This study aimed to explore the technical feasibility of measuring the insertional torque of a pedicle screw, while investigating

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