INTRODUCTION: The aim of this study is to compare the rate of screw loosening and clinical outcomes of expandable pedicle screws (EPS) with those of conventional pedicle screws (CPS) in patients treated for spinal stenosis (SS) combined with osteoporosis. METHODS:One hundred and fifty-seven consecutive patients with SS received eitherEPS fixation (n = 80) or CPS fixation (n = 77) to obtain lumbosacral stabilization. Patients were observed for a minimum of 24 months. Outcome measures included screw loosening, fusion rate, Japanese Orthopaedic Association (JOA) scores and Oswestry disability index (ODI) scoring system, and complications. RESULTS: In the EPS group, 20 screws became loose (4.1%) in 6 patients (7.5%), and two screws (0.4%) had broken. In the CPS group, 48 screws became loose (12.9%) in 15 patients (19.5%), but no screws were broken. The fusion rate in the EPS group (92.5%) was significantly higher than that of the CPS group (80.5%). The rate of screw loosening in the EPS group (4.1%) was significantly lower than that of the CPS group (12.9%). Six EPS (1.8%) screws were removed. In the EPS group, two screws had broken but without neural complications. Twelve months after surgeries, JOA and ODI scores in the EPS group were significantly improved. There were four cases of dural tears, which healed after corresponding treatment. CONCLUSIONS: EPS can decrease the risk of screw loosening and achieve better fixation strength and clinical results in osteoporotic lumbar spine fusion.
RCT Entities:
INTRODUCTION: The aim of this study is to compare the rate of screw loosening and clinical outcomes of expandable pedicle screws (EPS) with those of conventional pedicle screws (CPS) in patients treated for spinal stenosis (SS) combined with osteoporosis. METHODS: One hundred and fifty-seven consecutive patients with SS received either EPS fixation (n = 80) or CPS fixation (n = 77) to obtain lumbosacral stabilization. Patients were observed for a minimum of 24 months. Outcome measures included screw loosening, fusion rate, Japanese Orthopaedic Association (JOA) scores and Oswestry disability index (ODI) scoring system, and complications. RESULTS: In the EPS group, 20 screws became loose (4.1%) in 6 patients (7.5%), and two screws (0.4%) had broken. In the CPS group, 48 screws became loose (12.9%) in 15 patients (19.5%), but no screws were broken. The fusion rate in the EPS group (92.5%) was significantly higher than that of the CPS group (80.5%). The rate of screw loosening in the EPS group (4.1%) was significantly lower than that of the CPS group (12.9%). Six EPS (1.8%) screws were removed. In the EPS group, two screws had broken but without neural complications. Twelve months after surgeries, JOA and ODI scores in the EPS group were significantly improved. There were four cases of dural tears, which healed after corresponding treatment. CONCLUSIONS:EPS can decrease the risk of screw loosening and achieve better fixation strength and clinical results in osteoporotic lumbar spine fusion.
Authors: Lukas Weiser; Gerd Huber; Kay Sellenschloh; Lennart Viezens; Klaus Püschel; Michael M Morlock; Wolfgang Lehmann Journal: Eur Spine J Date: 2018-06-09 Impact factor: 3.134
Authors: Michael Werner; Niels Hammer; Christian Rotsch; Isabell Berthold; Mario Leimert Journal: Med Biol Eng Comput Date: 2019-11-18 Impact factor: 2.602
Authors: Lukas Weiser; Kay Sellenschloh; Klaus Püschel; Michael M Morlock; Lennart Viezens; Wolfgang Lehmann; Gerd Huber Journal: Eur Spine J Date: 2020-09-17 Impact factor: 3.134
Authors: Georg Osterhoff; Andrew E Dodd; Florence Unno; Angus Wong; Shahram Amiri; Kelly A Lefaivre; Pierre Guy Journal: Clin Orthop Relat Res Date: 2016-06-22 Impact factor: 4.176