Literature DB >> 28324215

Surgical treatment of osteoporotic thoraco-lumbar compressive fractures: the use of pedicle screw with augmentation PMMA.

Massimo Girardo1, P Cinnella2, G Gargiulo2, P Viglierchio2, A Rava3, S Aleotti2.   

Abstract

INTRODUCTION: The osteoporosis prevalence in population is age related. The aim of this single-center observational study was evaluate the middle- to long-term performance of cement (PMMA) augmented fenestrated pedicle screws in elderly patients with thoraco-lumbar compressive fractures by osteoporosis.
MATERIALS AND METHODS: From 2011 to 2015 we treated 52 patients (20 males and 32 females) suffering from somatic osteoporotic fractures (T10-L2). The average age was 73.4 years, with an age range between 65 and 82 years. The treatment consisted of stabilization with pedicle screw augmentation with PMMA cement. Patients were clinically evaluated with Visual Analyzing System scale (VAS scale) and with low back disability questionnaire Oswestry, in pre and post surgery and during the follow up at 12 and 24 months.
RESULTS: A total of 410 fenestrated pedicle screws with PMMA augmentation were implanted. No cases of loosening or pulling out of screws were recorded. There have been n 3 cases of thrombophlebitis, treated with oral anticoagulant drugs and 1 case of post-operative death due to ventricular fibrillation. No neurological complications occurred during the study. The mean VAS score decreased from 8.5 to 4.8 and the result remained stable during follow up. Oswestry questionnaire showed a mean decrease of low back pain of 24% in post-op period.
CONCLUSION: Fenestrated screws with PMMA augmentation offers a possibility to treat patients with reduced bone quality due to severe osteoporosis.

Entities:  

Keywords:  Fenestrated pedicle screws; Fractures; Osteoporosis

Mesh:

Substances:

Year:  2017        PMID: 28324215     DOI: 10.1007/s00586-017-5037-3

Source DB:  PubMed          Journal:  Eur Spine J        ISSN: 0940-6719            Impact factor:   3.134


  24 in total

Review 1.  The Oswestry Disability Index.

Authors:  J C Fairbank; P B Pynsent
Journal:  Spine (Phila Pa 1976)       Date:  2000-11-15       Impact factor: 3.468

2.  Hydroxyapatite dip coated and uncoated titanium poly-axial pedicle screws: an in vivo bovine model.

Authors:  Omer S Yildirim; Bunyamin Aksakal; Salih C Hanyaloglu; Fazli Erdogan; Ali Okur
Journal:  Spine (Phila Pa 1976)       Date:  2006-04-15       Impact factor: 3.468

Review 3.  Anatomic and technical considerations of pedicle screw fixation.

Authors:  J N Weinstein; B L Rydevik; W Rauschning
Journal:  Clin Orthop Relat Res       Date:  1992-11       Impact factor: 4.176

4.  Revision pedicle screws. Bigger, longer shims--what is best?

Authors:  D W Polly; J R Orchowski; R G Ellenbogen
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5.  Hydroxyapatite coating improves fixation of pedicle screws. A clinical study.

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6.  Biomechanical performance of the new BeadEx implant in the treatment of osteoporotic vertebral body compression fractures: restoration and maintenance of height and stability.

Authors:  A Kettler; W Schmoelz; Y Shezifi; N Ohana; A Ben-Arye; L Claes; H-J Wilke
Journal:  Clin Biomech (Bristol, Avon)       Date:  2006-03-29       Impact factor: 2.063

7.  Efficacy of novel-concept pedicle screw fixation augmented with calcium phosphate cement in the osteoporotic spine.

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8.  Effect of screw diameter, insertion technique, and bone cement augmentation of pedicular screw fixation strength.

Authors:  R H Wittenberg; K S Lee; M Shea; A A White; W C Hayes
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9.  Polymethylmethacrylate augmentation of pedicle screw for osteoporotic spinal surgery: a novel technique.

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10.  Fenestrated pedicle screws for cement-augmented purchase in patients with bone softening: a review of 21 cases.

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  14 in total

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Authors:  G Gargiulo; M Girardo; A Rava; A Coniglio; P Cinnella; A Massè; F Fusini
Journal:  Eur J Orthop Surg Traumatol       Date:  2019-02-08

2.  Different pedicle osteosynthesis for thoracolumbar vertebral fractures in elderly patients.

Authors:  Massimo Girardo; Alessandro Rava; Federico Fusini; Giosuè Gargiulo; Angela Coniglio; Pasquale Cinnella
Journal:  Eur Spine J       Date:  2018-05-14       Impact factor: 3.134

3.  Effectiveness and reliability of cannulated fenestrated screws augmented with polymethylmethacrylate cement in the surgical treatment of osteoporotic vertebral fractures.

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4.  Is cast an option in the treatment of thoracolumbar vertebral fractures?

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5.  Clinical and radiological union rate evaluation of type 2 odontoid fractures: A comparison between anterior screw fixation and halo vest in elderly patients.

Authors:  Massimo Girardo; Alessandro Rava; Giosuè Gargiulo; Angela Coniglio; Stefano Artiaco; Alessandro Massè; Federico Fusini
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6.  Over 70° thoracic idiopathic scoliosis: Results with screws or hybrid constructs.

Authors:  Pasquale Cinnella; Alessandro Rava; Antonio Abed Mahagna; Federico Fusini; Alessandro Masse; Massimo Girardo
Journal:  J Craniovertebr Junction Spine       Date:  2019 Apr-Jun

Review 7.  Surgical Trend Analysis for Use of Cement Augmented Pedicle Screws in Osteoporosis of Spine: A Systematic Review (2000-2017).

Authors:  Vishwajeet Singh; Rajat Mahajan; Kalidutta Das; Harvinder Singh Chhabra; Tarush Rustagi
Journal:  Global Spine J       Date:  2018-09-27

8.  Surgical treatment of spinal deformities in Marfan syndrome: Long-term follow-up results using different instrumentations.

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Journal:  J Craniovertebr Junction Spine       Date:  2019 Jul-Sep

9.  Safety and efficacy studies of kyphoplasty, mesh-container-plasty, and pedicle screw fixation plus vertebroplasty for thoracolumbar osteoporotic vertebral burst fractures.

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10.  Effects of polymethylmethacrylate on the stability of screw fixation in mandibular angle fractures: A study on sheep mandibles.

Authors:  Abdulkadir Burak Cankaya; Metin Berk Kasapoglu; Mehmet Ali Erdem; Cetin Kasapoglu
Journal:  Int J Med Sci       Date:  2018-09-11       Impact factor: 3.738

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