Reduced loosening rate and loss of correction following posterior stabilization with or without PMMA augmentation of pedicle screws in vertebral fractures in the elderly

Saman, Abdul; Meier, Simon; Sander, Anna; Kelm, Arne; Marzi, Ingo; Laurer, Helmut

doi:10.1007/s00068-013-0310-6

Cited by 103 publications

(69 citation statements)

References 30 publications

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“…Pedicle screw constructs are widely used to treat fractures, degenerative diseases, tumors and infection of the thoracolumbar spine as well as to correct spinal deformity [8]. Loosening of pedicle screws, however, may result in loss of reduction, spinal instability, painful nonunion after fusion and possibly even in recurrent pain despite successful fusion, and therefore may necessitate revision surgery [9][10][11][12]. There is an ongoing debate on how to improve pedicle screw anchorage and prevent screw loosening, and various strategies have been considered and evaluated.…”

Section: Introductionmentioning

confidence: 99%

Pedicle screw anchorage of carbon fiber-reinforced PEEK screws under cyclic loading

Lindtner

Schmid

Nydegger³

et al. 2018

Eur Spine J

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Using nonmetallic CF/PEEK instead of standard titanium as pedicle screw material did not affect screw loosening in the chosen test setup, whereas cement augmentation enhanced screw anchorage of CF/PEEK screws. While comparable to titanium screws in terms of screw loosening, radiolucent CF/PEEK pedicle screws offer the significant advantage of not interfering with postoperative imaging and radiotherapy. These slides can be retrieved under Electronic Supplementary Material.

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Section: Introductionmentioning

confidence: 99%

Pedicle screw anchorage of carbon fiber-reinforced PEEK screws under cyclic loading

Lindtner

Schmid

Nydegger³

et al. 2018

Eur Spine J

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“…Only three researches performed a controlled study relating to CAPS and noncement screws. El Saman et al 31 noted the loosening rate of CAPSs is 4.3%, whereas in noncement screws group, the loosening rate was 62.8%. Thus, a significantly lower loosening rate was showed in CAPSs compared to noncement ones.…”

Section: Discussionmentioning

confidence: 98%

Clinical efficacy of Bone Cement-injectable Cannulated Pedicle Screw Short Segment Fixation for Lumbar Spondylolisthesis with Osteoporosise

Liu

Xiao

Yin

et al. 2020

Sci Rep

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Many clinical studies have shown a satisfactory clinical efficacy using bone cement-augmented pedicle screw in osteoporotic spine, however, few studies have involved the application of this type of screw in lumbar spondylolisthesis. This study aims to investigate the mid-term clinical outcome of bone cementinjectable cannulated pedicle screw (CICPS) in lumbar spondylolisthesis with osteoporosis. From 2011 to 2015, twenty-three patients with transforminal lumbar interbody fusion (TLIF) using CICPS for lumbar spondylolisthesis were enrolled in the study. Oswestry Disability Index (ODI) and Visual Analogue Scale (VAS) were used to evaluate faunctional recovery and physical pain; and operation time, blood loss and hospitalization time were recorded, respectively. Radiograph and computed tomography of lumbar spine was performed to assess loss of the intervertebral disc space height, fixation loosening, and the rate of bony fusion. The average follow-up time of 23 patients was 22.5 ± 10.2 months (range, 6-36 months). According to VAS and ODI scores, postoperative pain sensation and activity function were significantly improved (p < 0.05). The height of the intervertebral disc space was reduced by 0.4 ± 1.1 mm, and the bone graft fusion rate was 100%. No cases of internal fixation loosening or screw pullout was observed. CICPS using cement augmentation may suggest as a feasible surgical technique in osteoporotic patients with lumbar spondylolisthesis.

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“…2,3 Screw failure is especially prevalent following procedures that treat patients with poor bone quality, [3][4][5] and is one of the primary causes of revision procedures for orthopaedic hardware. 4 These revision procedures typically require extensive preoperative planning, the use of specialized implants and tools and mastery of technically challenging surgical techniques that dramatically raise health care costs. 6 There is a wide range of screw failure processes that can include screw backout, stripping, complete fracture or loosening due to infection.…”

Section: Introductionmentioning

confidence: 99%

Biomechanical and Histological Assessment of a Polyethylene Terephthalate Screw Retention Technology in an Ovine Metatarsal Fracture Model

Easley

Puttlitz

Broomfield

et al. 2020

Vet Comp Orthop Traumatol

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Objective Screw loosening in fracture fixation poses a clinical risk which may lead to implant failure, particularly in poor bone quality. The objective of this study was to examine the effectiveness of a novel screw retention technology (SRT) for increased screw purchase in a large animal metatarsal fracture model. Study Design This was a biomechanical, radiographic, and histological study utilizing an ovine metatarsal fracture model. Twenty-four sheep metatarsi underwent 3-mm ostectomies and were repaired with a nine-hole plate and 3.5-mm screws placed in oversized 3.5-mm holes to simulate worst case revision surgeries (i.e. no initial screw thread bone contact). Sheep were sacrificed at 3, 6 or 12 weeks (n = 6 each) post-operation. Post-sacrifice, each surgically implanted screw underwent either destructive mechanical testing or histomorphometric analyses. Results Treated metatarsi showed improved screw retention and normal fracture healing. Significant improvement in breakout strength and pullout strength of screws treated with the SRT were found as a function of healing time. Histologically, bone ingrowth at the screw interface was also shown to significantly increase with healing time. Improvements in fracture healing, indicated by an increase in bone fraction and decrease in void space at the osteotomy, were also observed with healing time. Conclusion The results demonstrate the effectiveness of the SRT as a method for improved screw retention in a rescue-screw type scenario.

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Reduced loosening rate and loss of correction following posterior stabilization with or without PMMA augmentation of pedicle screws in vertebral fractures in the elderly

Abstract: The reinforcement of pedicle screws using PMMA augmentation may be a viable option in the surgical treatment of spinal fractures in the elderly.

Cited by 103 publications

References 30 publications

Pedicle screw anchorage of carbon fiber-reinforced PEEK screws under cyclic loading

Pedicle screw anchorage of carbon fiber-reinforced PEEK screws under cyclic loading

Clinical efficacy of Bone Cement-injectable Cannulated Pedicle Screw Short Segment Fixation for Lumbar Spondylolisthesis with Osteoporosise

Biomechanical and Histological Assessment of a Polyethylene Terephthalate Screw Retention Technology in an Ovine Metatarsal Fracture Model

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