• Graham Mulvaney, Mareshah N Sowah, Rebecca DeCarlo, Peter Drossopoulos, Christopher M Holland, and Michael A Bohl.
• Department of Neurosurgery, Atrium Health Carolinas Medical Center, Charlotte, North Carolina, USA. Electronic address: GM.Research@outlook.com.
• World Neurosurg. 2024 Oct 1; 190: e675e683e675-e683.

ObjectiveTo investigate the biomechanical properties of pedicle screw reinsertion along the same trajectory in a previously validated synthetic bone model.MethodsTwenty identical acrylonitrile butadiene styrene models of lumbar vertebrae were three-dimensional-printed. Screws were placed in the standard fashion into each pedicle. Models were separated into 2 equal groups, control and experimental. Experimental group screws were completely removed from their testing block and reinserted once. All screws in both groups were then forcibly removed. Continuous torque monitoring was collected on screw insertion torque (IT), removal torque, and reinsertion torque. Pullout strength (PO), screw stiffness (STI), and strain energy (STR) were calculated.ResultsThere was no significant difference between control and experimental groups for PO (P = 0.26), STI (P = 0.55), STR (P = 0.50), or IT (P = 0.24). There was a significant decrease in reinsertion torque (54.5 N-cm ± 8.2 N-cm) from control IT (62.9 N-cm ± 8.4 N-cm, P = 0.045) and experimental IT (67.5 N-cm ± 7.6 N-cm, P = 0.0026). Strong correlations (Pearson's r > 0.80) were seen between control IT against STR and PO, between each of the experimental torque measurements, and between experimental PO and STI.ConclusionsDespite a significant decrease in insertion torque, there is no significant loss of pedicle screw performance when a screw is removed and reinserted along the same trajectory.Copyright © 2024. Published by Elsevier Inc.

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