Posterior Vertebral Column Resection Combined With Bone Cement Augmentation of Pedicle Screw Fixation for Treatment of Severe Vertebral Compression Fractures With Kyphotic Deformity

OBJECT In elderly patients with severe osteoporosis, instrumented lumbar interbody fusion may result in fixation failure or nonunion because of decreased pedicle screw pullout strength or increased interbody graft subsidence risk. Thus, given its many advantages, percutaneous pedicle screw fixation with cement augmentation can be an effective method to use in elderly patients. The authors report on an easy, safe, and economical technique for bone cement augmentation using a bone biopsy needle inserted into the disc space in 2 osteoporotic patients who were treated with posterior interbody fusion and percutaneous pedicle screw fixation. METHODS Two elderly patients who complained of back pain and intermittent neurological claudication underwent posterior interbody fusion with percutaneous pedicle screw fixation. After routinely assembling rods on the screws, a bone biopsy needle was inserted into the disc space via the operative field; the needle was then placed around the tips of the screws using fluoroscopic radiography for guidance. Bone cement was injected through the bone biopsy needle, also under fluoroscopic radiography guidance. RESULTS Both patients’ symptoms improved after the operation, and there was no evidence of cage subsidence or screw loosening at the 4-month follow-up. CONCLUSIONS The indirect technique of bone cement augmentation via the disc space for percutaneous screw fixation could be an easy, safe, and economical method.

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Vertebroplasty and vertebroplasty in combination with intermediate bilateral pedicle screw fixation for OF4 in osteoporotic vertebral compression fractures: a retrospective single-Centre cohort study

BMC Surgery ◽

10.1186/s12893-019-0646-x ◽

2019 ◽

Vol 19 (1) ◽

Cited By ~ 2

Author(s):

Weiyang Zhong ◽

Xinjie Liang ◽

Xiaoji Luo ◽

Zhengxue Quan

Keyword(s):

Pedicle Screw ◽

Screw Fixation ◽

Pedicle Screw Fixation ◽

Vertebral Compression Fractures ◽

Osteoporotic Vertebral Compression Fractures ◽

Compression Fractures ◽

Group A ◽

Group B ◽

Bilateral Pedicle Screw

Abstract Background Although various studies have described the outcomes and complications of each treatment for OF 4 in osteoporotic vertebral compression fractures (OVCFs), there is still no consensus on the optimal treatment regimen. This study aimed to investigate the clinical effect of OF 4 in patients with OVCFs treated with percutaneous vertebroplasty (PV) compared with PV in combination with intermediate bilateral pedicle screw fixation (IBPSF). Methods A total of 110 patients with OF 4 in OVCFs from January 2011 to December 2013 were reviewed retrospectively and divided into two groups (group A: PV, group B: PV + IBPSF). According to the guidelines of the German Society for Orthopaedics and Trauma (DGOU), OF 4 consists of 3 fracture types. The clinical and radiographic assessments were observed preoperatively, postoperatively, and during follow-up. Results The patients were followed for an average of 60.50 ± 15.20 months (group A) and 58.20 ± 17.60 months (group B) without significant differences. No significant differences were found in BMD, BMI and cement volume between the two groups, but differences were found for operation time, blood loss, and hospitalization time. The VAS and ODI scores improved better significantly at the final follow-up in group B but not in group A. Compared with the preoperative values, the postoperative kyphosis angle and loss of fractured segment height significantly improved, but the difference between the groups was significant after 3 months postoperatively. The loss of angular correction and fractured segment height in group A were greater than those in group B. A total of 15 cases of cement leakage were observed in group A and 8 cases in group B, and no complications or revision surgeries were observed in either group. Thirteen new fractures occurred (11 in group A and 2 in group B), which was significant. Conclusion PV with IBPSF could provide effective restoration and maintenance of fractured segment height and segment alignment as well as a lower rate of complications of OF 4 in OVCFs.

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Comparison of Percutaneous Kyphoplasty and Percutaneous Pedicle Screw Fixation for the Treatment of Osteopenic Thoracolumbar Vertebral Compression Fractures

10.21203/rs.3.rs-101435/v1 ◽

2020 ◽

Author(s):

Ye Zhang ◽

Weiwei Yi ◽

Huiqiang Xia ◽

Haiyang Lan ◽

Zhijie Yang ◽

...

Keyword(s):

Pedicle Screw ◽

Screw Fixation ◽

Pedicle Screw Fixation ◽

Long Term Results ◽

Vertebral Compression Fractures ◽

Compression Fractures ◽

Percutaneous Kyphoplasty ◽

Percutaneous Pedicle Screw ◽

Percutaneous Pedicle Screw Fixation

Abstract BACKGROUND: Osteoporotic vertebral compression fractures (OVCFs) have a high incidence, which have attracted wide attention from society. However, few scholars have conducted researches on osteopenic vertebral compression fractures (osteopenic VCFs). Our research has compared the clinical and imaging effects of percutaneous kyphoplasty (PKP) and percutaneous pedicle screw fixation (PPSF) in the treatment of Osteopenic thoracolumbar vertebral compression fractures (Osteopenic VCFs).METHODS: From December 2018 to September 2020, 70 patients with osteopenic VCFs who had undergone PKP and PPSF surgeries at our medical center were reviewed retrospectively. All patients were divided into PKP group (n=38) and PPSF group (n=32). Clinical data including clinical and radiological evaluation results were performed pre- and postoperatively.RESULTS: The operation time, bleeding volume, postoperative bedtime, and hospitalization period in PKP group were lower than those in PPSF group (P<0.05). The visual analogue scale (VAS) and Oswestry Disability Index (ODI) of two groups in the last follow-up were lower than those before the operation (P<0.05). On the 3rd day after the operation, VAS and ODI in PPSF group were higher than those in PKP group (P<0.05). The anterior height of injured vertebrae (AH) of two groups was recovered compared with that before the operation. Compared with two groups in each period, there was no obvious difference in AH or the height restoration of injured vertebrae (HR) (P>0.05). The anterior height ratio of injured vertebrae (AHR) of PPSF group was higher than that of PKP group after the operation (P<0.05). The kyphosis angle (KA) in PPSF group was smaller than PKP group after the operation (P<0.05). All patients in PPSF group have achieved bony healing at the last follow-up.CONCLUTIONS: Both PPSF and PKP can achieve satisfactory clinical results in the treatment of Osteopenic VCFs. The short-term clinical effect of PKP is better than that of PPSF, but the latter has better long-term results, including the correction and maintenance of vertebral height and the acquisition of osseous fusion.

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Long-term efficacy and safety of bone cement-augmented pedicle screw fixation for stage III Kümmell diseaseLong-term efficacy and safety of bone cement-augmented pedicle screw fixation for stage III Kümmell disease

10.21203/rs.2.22708/v1 ◽

2020 ◽

Author(s):

Guo-ye Mo ◽

Teng-peng Zhou ◽

Yong-xian Li ◽

Hui-zhi Guo ◽

Dan-qing Guo ◽

...

Keyword(s):

Cobb Angle ◽

Bone Cement ◽

Pedicle Screw ◽

Screw Fixation ◽

Operation Time ◽

Pedicle Screw Fixation ◽

Stage Iii ◽

Efficacy And Safety ◽

Sagittal Vertical Axis ◽

Term Efficacy

Abstract Purpose This study aimed to evaluate the efficacy and safety of bone cement-augmented pedicle screw fixation for stage III Kümmell disease. Methods Twenty-five patients with stage III Kümmell disease who received bone cement-augmented pedicle screw fixation at the First Affiliated Hospital of Guangzhou University of Chinese Medicine between June 2009 and December 2015 were enrolled. All patients were females with a history of osteoporosis. The vertebral Cobb angle (V-Cobb angle), the fixed segment Cobb Angle (S-Cobb angle), pelvic parameters, visual Analogue Scale (VAS) score, and Oswestry Disability Index (ODI) were assessed preoperatively, postoperatively and at the final follow-up. Complications, loosening rate, operation time, and intraoperative bleeding were recorded. Results The average lumbar vertebral density T-value was -3.68 ± 0.71 SD, and the average age was 71.84 ± 5.39. The V-Cobb angle, S-Cobb angle, and Sagittal Vertical Axis（SVA） were significantly smaller postoperatively compared to the preoperative values. The VAS and ODI at 1 month after surgery were 3.60 ± 1.00 and 36.04 ± 6.12%, respectively, which were both significantly lower than before surgery (VAS: 8.56±1.04, ODI: 77.80 ± 6.57%). Conclusion Bone cement-augmented pedicle screw fixation is a safe and effective treatment for stage III Kümmell disease. It can effectively correct kyphosis, restore and maintain sagittal balance, and maintain spinal stability.

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