Comparison of the fenestrated pedicle screw and conventional pedicle screw in minimally percutaneous fixation for the treatment of spondylolisthesis with osteoporotic spine

2019 ◽  
Vol 183 ◽  
pp. 105377 ◽  
Author(s):  
Wenkai Wang ◽  
Chao Liu ◽  
Jie Li ◽  
Haiyin Li ◽  
Junlong Wu ◽  
...  
Keyword(s):  
Pedicle Screw ◽  
Percutaneous Fixation ◽  
Fenestrated Pedicle Screw

scholarly journals The Role of Prophylactic Vertebroplasty at UIV+1 and Cement-augmented Fenestrated Pedicle Screw for Prevention of PJK/PJF  in Patients With Osteoporosis: A Propensity Score–matched Analysis

2020 ◽  
Author(s):  
Qi Wang ◽  
Chi Wang ◽  
Wenhao Hu ◽  
Fanqi Hu ◽  
Weibo Liu ◽  
...  
Keyword(s):  
Propensity Score ◽  
Pedicle Screw ◽  
Adult Spinal Deformity ◽  
Cement Leakage ◽  
Cement Augmentation ◽  
Screw Loosening ◽  
Group A ◽  
Pedicle Screw Loosening ◽  
Fenestrated Pedicle Screw

Abstract Objective: To elucidate the role of prophylactic vertebroplasty (PV) at UIV+1 and cement-augmented fenestrated pedicle screw (CAFPS) in prevention of PJK and PJF.Background: Cement augmentation at UIV and UIV+1 was found to prevent PJK and PJF. But most studies are retrospective and have a selection bias due to multifactorial etiology of PJF, making it difficult to identify the efficacy of prophylactic cement augmentation. Methods: We enrolled 208 surgically treated adult spinal deformity (ASD) patients who were followed for at least 2 years, to elucidate whether prophylactic cement augmentation was truly minimizing the risk of PJK and PJF in a uniform population from one center database. Patients were classified into two groups. Two comparable groups were propensity-matched with one to one nearest neighbor matching. The main outcome variables including PJK, PJF, pedicle screw loosening and cement leakage were compared.Results：After propensity score matching, there were 58 propensity-matched patients in group A and B (n=29 in each group) whose parameters including age, BMI, BMD, number of instrumented vertebrae, SVA, spinal-pelvic parameters and the frequency of UIV and LIV were similar. The incidence of PJK showed no significantly statistical difference between group A and B (10.3% vs 13.8%, p >0.99). Compared to group A, group B had a higher proportion of patients developing PJF (24.1% vs 0%, p=0.01). Pedicle screw loosening at UIV and (or) LIV showed no difference (24.1% vs 3.4%, p=0.052) between two groups. In group A, cement leakage was detected in 5 cases via fluoroscopy, but none of them had neurological deficit or pulmonary cement embolism.Conclusion: Combined application of CAFPS and PV could reduce the incidence of PJF, but it could not prevent the development of PJK in the surgical management of ASD with low BMD or osteoporosis.

Cirq® Robotic Assistance for Minimally Invasive C1-C2 Posterior Instrumentation: Report on Feasibility and Safety

2020 ◽  
Author(s):  
Kaissar Farah ◽  
Mikael Meyer ◽  
Solene Prost ◽  
Henry Dufour ◽  
Benjamin Blondel ◽  
...  
Keyword(s):  
Radiation Dose ◽  
Pedicle Screw ◽  
Navigation System ◽  
Posterior Instrumentation ◽  
Screw Placement ◽  
Upper Cervical Spine ◽  
Robotic Assistance ◽  
Percutaneous Fixation ◽  
Neurological Patient ◽  
Traumatic Fracture

Abstract BACKGROUND Accurate screw placement remains very challenging especially in the upper cervical spine. OBJECTIVE To present our first experience of a percutaneous posterior C1-C2 fixation for a traumatic fracture. METHODS This is a case report of a non-neurological patient, harboring a type II odontoid fracture. She underwent a posterior percutaneous fixation using Cirq® Robotic Assistance coupled to the AIRO® intraoperative computed tomography (iCT)-scan and BrainLab® navigation system (all by BrainLab AG). Routine CT was performed on postoperative day 2 to evaluate pedicle screw placement. The effective dose was calculated. RESULTS The C1-C2 posterior percutaneous fixation was performed with cannulated VERTEX® Reconstruction System (Medtronic). Overall, 4 screws were placed. All of them were rated as acceptable (100%). Radiation dose received by the patient was 4.13 mSv. Radiation dose received by the surgical staff was 0 mSv. Postoperative course was excellent. CONCLUSION Posterior percutaneous fixation using Cirq® Robotic Assistance coupled with iCT navigation system is a major innovation that can improve pedicle screw positioning's accuracy with acceptable patient radiation and reduced surgical team exposure.

P151. Two-year experience with fenestrated pedicle screw cement augmentation in spine surgery: a safety and efficacy study

2019 ◽  
Vol 19 (9) ◽  
pp. S228
Author(s):  
Ruwan Ratnayake ◽  
Houssam Bouloussa ◽  
Kamran Majid ◽  
Calvin C. Kuo ◽  
Ravi S. Bains
Keyword(s):  
Pedicle Screw ◽  
Spine Surgery ◽  
Cement Augmentation ◽  
Efficacy Study ◽  
Safety And Efficacy ◽  
Fenestrated Pedicle Screw

P54. Pullout Resistance Provided by a New Fenestrated Pedicle Screw in Vertebrae with Compromised Bone Mineral Density

2008 ◽  
Vol 8 (5) ◽  
pp. 127S-128S
Author(s):  
Anton Dmitriev ◽  
James Chappuis ◽  
Melvin Helgeson ◽  
Philippe Pare ◽  
Allison Gasperut ◽  
...  
Keyword(s):  
Bone Mineral Density ◽  
Pedicle Screw ◽  
Bone Mineral ◽  
Mineral Density ◽  
Pullout Resistance ◽  
Fenestrated Pedicle Screw

Perfusion pressure of a new cannulating fenestrated pedicle screw during cement augmentation

2018 ◽  
Vol 57 ◽  
pp. 42-47
Author(s):  
Zhirong Wang ◽  
Wen Zhang ◽  
Hao Xu ◽  
Aiqing Lu ◽  
Huilin Yang ◽  
...  
Keyword(s):  
Pedicle Screw ◽  
Perfusion Pressure ◽  
Cement Augmentation ◽  
Fenestrated Pedicle Screw

Biomechanical Evaluation of a Novel Fenestrated Pedicle Screw Augmented With Bone Cement in Osteoporotic Spines

Spine ◽  
2011 ◽  
Vol 36 (18) ◽  
pp. E1210-E1214 ◽  
Author(s):  
Philippe E. Paré ◽  
James L. Chappuis ◽  
Raja Rampersaud ◽  
Amit O. Agarwala ◽  
Joseph H. Perra ◽  
...  
Keyword(s):  
Bone Cement ◽  
Pedicle Screw ◽  
Biomechanical Evaluation ◽  
Fenestrated Pedicle Screw

P110. Improved sacral fixation using a new fenestrated pedicle screw with PMMA

2005 ◽  
Vol 5 (4) ◽  
pp. S164
Author(s):  
Darrel S. Brodke ◽  
Jonathan Pond ◽  
Kent N. Bachus ◽  
James Chappius
Keyword(s):  
Pedicle Screw ◽  
Fenestrated Pedicle Screw

scholarly journals Augmented PMMA distribution: improvement of mechanical property and reduction of leakage rate of a fenestrated pedicle screw with diameter-tapered perforations

2016 ◽  
Vol 24 (6) ◽  
pp. 971-977 ◽  
Author(s):  
Quan-chang Tan ◽  
Jian-wei Wu ◽  
Fei Peng ◽  
Yuan Zang ◽  
Yang Li ◽  
...  
Keyword(s):  
Pedicle Screw ◽  
Statistical Significance ◽  
Cement Leakage ◽  
Leakage Rate ◽  
Distribution Characteristics ◽  
Pullout Strength ◽  
Injection Volume ◽  
Study Results ◽  
Fenestrated Pedicle Screw ◽  
Pmma Cement

OBJECTIVE This study investigated the optimum injection volume of polymethylmethacrylate (PMMA) to augment a novel fenestrated pedicle screw (FPS) with diameter-tapered perforations in the osteoporotic vertebral body, and how the distribution characteristics of PMMA affect the biomechanical performance of this screw. METHODS Two types of FPSs were designed (FPS-A, composed of 6 perforations with an equal diameter of 1.2 mm; and FPS-B, composed of 6 perforations each with a tapered diameter of 1.5 mm, 1.2 mm, and 0.9 mm from tip to head. Each of 28 human cadaveric osteoporotic vertebrae were randomly assigned to 1 of 7 groups: FPS-A1.0: FPS-A+1.0 ml PMMA; FPS-A1.5: FPS-A+1.5 ml PMMA; FPS-A2.0: FPS-A+2.0 ml PMMA; FPS-B1.0: FPS-B+1.0 ml PMMA; FPS-B1.5: FPS-B+1.5 ml PMMA; FPS-B2.0: FPS-B+2.0 ml PMMA; and conventional pedicle screws (CPSs) without PMMA. After the augmentation, 3D CT was performed to assess the cement distribution characteristics and the cement leakage rate. Axial pullout tests were performed to compare the maximum pullout force thereafter. RESULTS The CT construction images showed that PMMA bone cement formed a conical mass around FPS-A and a cylindrical mass around FPS-B. When the injection volume was increased from 1.0 ml to 2.0 ml, the distribution region of the PMMA cement was enlarged, the PMMA was distributed more posteriorly, and the risk of leakage was increased. When the injection volume reached 2.0 ml, the risk of cement leakage was lower for screws having diameter-tapered perforations. The pullout strengths of the augmented FPS-A groups and FPS-B groups were higher than that of the CPS group (p < 0.0001). All FPS-B groups had a higher pullout strength than the FPS-A groups. CONCLUSIONS The diameter of the perforations affects the distribution of PMMA cement. The diameter-tapered design enabled PMMA to form larger bone-PMMA interfaces and achieve a relatively higher pullout strength, although statistical significance was not reached. Study results indicated 1.5-ml of PMMA was a conservative volume for PMMA augmentation; more cement injection would significantly increase the risk of cement leakage.

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