Biomechanical and finite element analyses of bone cement‐Injectable cannulated pedicle screw fixation in osteoporotic bone

Liu, Yaoyao; Xu, Jianzhong; Sun, Dong; Luo, Fei; Zhang, Zehua; Dai, Fei

doi:10.1002/jbm.b.33424

Cited by 23 publications

(17 citation statements)

References 42 publications

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“…Uniform distribution of the cement effectively avoids clinical complications related to cement leakage into the spinal canal. This type of cannulated screw is putatively significantly better compared with other existing types of cannulated screw systems 13,14.…”

Section: Discussionmentioning

confidence: 90%

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Clinical evaluation of a bone cement-injectable cannulated pedicle screw augmented with polymethylmethacrylate: 128 osteoporotic patients with 42 months of follow-up

Wang¹,

Liu²,

Rong³

et al. 2019

Clinics

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OBJECTIVES: To evaluate the safety and efficacy of a novel bone cement-injectable cannulated pedicle screw augmented with polymethylmethacrylate in osteoporotic spinal surgery. METHODS: This study included 128 patients with osteoporosis (BMD T-score –3.2±1.9; range, –5.4 to –2.5) who underwent spinal decompression and instrumentation with a polymethylmethacrylate-augmented bone cement-injectable cannulated pedicle screw. Postoperative Visual Analogue Scale scores and the Oswestry Disability Index were compared with preoperative values. Postoperative plain radiographs and computed tomography (CT) scans were performed immediately after surgery; at 1, 3, 6, and 12 months; and annually thereafter. RESULTS: The mean follow-up time was 42.4±13.4 months (range, 23 to 71 months). A total of 418 polymethylmethacrylate-augmented bone cement-injectable cannulated pedicle screws were used. Cement extravasations were detected in 27 bone cement-injectable cannulated pedicle screws (6.46%), mainly in cases of vertebral fracture, without any clinical sequela. The postoperative low back and lower limb Visual Analogue Scale scores were significantly reduced compared with the preoperative scores (<0.01), and similar results were noted for the Oswestry Disability Index score ( p <0.01). No significant screw migration was noted at the final follow-up relative to immediately after surgery ( p <0.01). All cases achieved successful bone fusion, and no case required revision. No infection or blood clots occurred after surgery. CONCLUSIONS: The polymethylmethacrylate-augmented bone cement-injectable cannulated pedicle screw is safe and effective for use in osteoporotic patients who require spinal instrumentation.

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Section: Discussionmentioning

confidence: 90%

“…We previously demonstrated the improved biomechanical stability of the polymethylmethacrylate (PMMA)-augmented CICPS in osteoporotic bone 13,14. In the present retrospective study, we evaluated the long-term safety and effectiveness of the PMMA-augmented CICPS in 128 osteoporotic patients with degenerative spinal diseases.…”

Section: Introductionmentioning

confidence: 93%

Clinical evaluation of a bone cement-injectable cannulated pedicle screw augmented with polymethylmethacrylate: 128 osteoporotic patients with 42 months of follow-up

Wang¹,

Liu²,

Rong³

et al. 2019

Clinics

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“…A suitable cage was filled with crushed autologous bone for fusion, then rods were installed and nuts were locked. In this study, a new type of PMMA-augmented CPS, named "bone cement injectable cannulated pedicle screw (CICP S)" was developed by the authors for reduction and fixation, a detailed introduction of which was reported in detail in previous studies [17][18][19][20].…”

Section: Surgical Methodsmentioning

confidence: 99%

Comparison of unilateral and bilateral polymethylmethacrylate-augmented cannulated pedicle screw fixation for the management of lumbar spondylolisthesis with osteoporosis

Liu¹,

Xiao

Jin³

et al. 2020

J Orthop Surg Res

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Background Cannulated pedicle screw (CPS) augmented by polymethylmethacrylate (PMMA) can achieve satisfactory clinical efficacy in the treatment of lumbar spondylolisthesis with osteoporosis. However, accurate application of CPSs will help to avoid the difficulty of screw revision and reduce the incidence of PMMA-related complications. This study aimed to investigate the mid-term efficacy of CPS compared to unilateral and bilateral applications in this common lumbar degenerative disease. Methods May 2011 and May 2018, 50 patients with lumbar spondylolisthesis with osteoporosis who underwent posterior fixation and fusion using traditional pedicle screws or CPSs were included in the study. Patients were divided into two groups based on the application: the unilateral PMMA-augmented CPS group (UC, n = 29) and the bilateral PMMA-augmented CPS group (BC, n = 21). Operation time, blood loss, average hospitalization time, PMMA leakage, and other complications were recorded. The visual analog scale (VAS) and Oswestry disability index (ODI) scores were used to evaluate symptom recovery. Radiographic results were compared for intervertebral fusion and screw loosening. Results There were no significant differences in the baseline data of the two groups. The VAS and ODI scores improved significantly after surgery (P < 0.05), with no significant differences between the groups (P > 0.05). The operation time and blood loss in the UC group were significantly lower than those in the BC group (P < 0.05). However, the loss of intervertebral disk height and Taillard index did not differ significantly between the groups. The rates of PMMA leakage in the UC and BC groups were 7.0% and 11.9%, respectively (P < 0.05). Bony fusion was achieved in all groups without screw loosening at the last follow-up. Only one patient experienced superficial infection in both groups, while cerebrospinal fluid leakage was observed in two patients in the BC group. Conclusions Unilateral application of PMMA-augmented CPS may provide adequate clinical safety and effectiveness in the surgical treatment of lumbar spondylolisthesis with osteoporosis.

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“…A suitable cage was lled with crushed autologous bone for fusion, then rods were installed and nuts were locked. In this study, a new type of PMMA-augmented CPS named bone cement-injectable cannulated pedicle screw (CICPS) was developed by authors for reduction and xation, a system introduction of which was reported in detail in previous literatures (17)(18)(19)(20).…”

Section: Surgical Methodsmentioning

confidence: 99%

Comparison of Unilateral and Bilateral Polymethylmethacrylate-augmented Cannulated Pedicle Screw Fixation for Management of Lumbar Spondylolisthesis with Osteoporosis

Liu¹,

Xiao

Jin³

et al. 2020

Preprint

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Background: Many studies have shown that cannulated pedicle screw (CPS) augmented by polymethylmethacrylate (PMMA) can obtain a satisfactory clinical efficacy in the treatment of lumbar spondylolisthesis with osteoporosis. However, accurate application of CPSs will help to avoid the difficulty of screw revision and reduce the incidence of PMMA related complications. This study aims to investigate the mid-term efficacy of CPS comparing unilateral and bilateral application in this common lumbar degenerative disease. Methods: Between May 2011 and May 2018, 50 patients with posterior fixation and fusion using traditional pedicle screw or CPSs for lumbar spondylolisthesis with osteoporosis were included in the study. Patients were divided into 2 groups: those with unilateral PMMA-augmented CPSs (group UC n=29) and those with bilateral PMMA-augmented CPSs (group BC, n=21). Operation time, blood loss, average hospitalization time, PMMA leakage and other complications were recorded. Visual Analog Scale (VAS) and Oswestry Disability Index (ODI) scores were used to evaluate the recovery of symptoms. Radiographic results were compared for the intervertebral fusion and screw loosening. Results: There were no significant differences in the baseline data of the 2 groups.VAS and ODI scores were improved significantly after surgery (P<0.05), with no differences between the groups (P>0.05). The operation time and blood loss in group UC were significantly lower than those in groups BC (P<0.05). However, the loss of intervertebral disc height and Taillard index had no difference in group UC compared with group BC. And the rates of PMMA leakage in group UC and BC were 7.0% and 11.9%, respectively (P<0.05). Bony fusion was achieved in all groups without screw loosening at the last follow-up. And only one patient experienced superficial infection in both groups, meanwhile two patients of cerebrospinal fluid leakage was observed in group BC.Conclusions: Unilateral application of PMMA-augmented CPS may provide adequate clinical safety and effectiveness in surgical treatment of lumbar spondylolisthesis with osteoporosis.

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Biomechanical and finite element analyses of bone cement‐Injectable cannulated pedicle screw fixation in osteoporotic bone

Cited by 23 publications

References 42 publications

Clinical evaluation of a bone cement-injectable cannulated pedicle screw augmented with polymethylmethacrylate: 128 osteoporotic patients with 42 months of follow-up

Clinical evaluation of a bone cement-injectable cannulated pedicle screw augmented with polymethylmethacrylate: 128 osteoporotic patients with 42 months of follow-up

Comparison of unilateral and bilateral polymethylmethacrylate-augmented cannulated pedicle screw fixation for the management of lumbar spondylolisthesis with osteoporosis

Comparison of Unilateral and Bilateral Polymethylmethacrylate-augmented Cannulated Pedicle Screw Fixation for Management of Lumbar Spondylolisthesis with Osteoporosis

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