Comparative Assessment of Sacral Screw Loosening Augmented With PMMA Versus a Calcium Triglyceride Bone Cement

2010 ◽  
Author(s):  
Stewart D. McLachlin ◽  
Khalid Al Saleh ◽  
Kevin R. Gurr ◽  
Stewart I. Bailey ◽  
Chris S. Bailey ◽  
...  
Keyword(s):  
Bone Cement ◽  
Pedicle Screw ◽  
Interface Strength ◽  
Comparative Assessment ◽  
Screw Loosening ◽  
Cyclic Bending ◽  
Bone Interface ◽  
Screw Augmentation ◽  
Bending Loads ◽  
Instrumentation Failure

Instrumentation failure in the S1 pedicles as a result of the screw loosening created by large cyclic bending loads is well documented. Biomechanical studies have shown that pedicle screw augmentation with Polymethylmethacrylate (PMMA) can result in improved screw-bone interface strength [1].

INVESTIGATION INTO WHETHER OR NOT PMMA BONE CEMENT TRANSPEDICULAR SCREW AUGMENTATION STABILIZES PEDICLE SCREW LOOSENING

2019 ◽  
Vol 19 (02) ◽  
pp. 1940024
Author(s):  
PO-YI LIU ◽  
SHENG-CHIH LIN ◽  
PO-LIANG LAI ◽  
CHUN-LI LIN
Keyword(s):  
Bone Cement ◽  
Pedicle Screw ◽  
Fatigue Resistance ◽  
Fatigue Testing ◽  
Pedicle Screw Fixation ◽  
Screw Loosening ◽  
General Technique ◽  
Screw Augmentation ◽  
Pmma Bone Cement ◽  
Pedicle Screw Loosening

Pedicle screw loosening at the bone–screw interface is the main complication in pedicle screw fixation. The transpedicular polymethylmethacrylate screw augmentation technique has recently become the general technique used to re-operatively overcome pedicle screw loosening. This study investigates the fatigue resistance of PMMA bone cement augmentation. Twenty-seven porcine thoracic vertebral bodies were collected. The BMD was measured using dual X-ray absorptiometry. Each vertebral body was instrumented with one pedicle screw and mounted in a material testing system. Fatigue testing was performed by implementing a cranio-caudal sinusoidal, cyclic (5[Formula: see text]Hz) load. This study shows that transpedicular pedicle screw augmentation with PMMA exhibits similar fatigue resistance as traditional pedicle screw implantation. However, in histomophometrical analysis, the transpedicular pedicle screw augmentation with PMMA has greater anti-deformation capacity than traditional pedicle screw implantation. Transpedicular pedicle screw augmentation with PMMA improves more screw holding power to prevent pedicle screw loosening.

scholarly journals Cement leakage in pedicle screw augmentation: a prospective analysis of 98 patients and 474 augmented pedicle screws

2016 ◽  
Vol 25 (1) ◽  
pp. 103-109 ◽  
Author(s):  
Jan U. Mueller ◽  
Joerg Baldauf ◽  
Sascha Marx ◽  
Michael Kirsch ◽  
Henry W. S. Schroeder ◽  
...  
Keyword(s):  
Pedicle Screw ◽  
Screw Fixation ◽  
Pedicle Screws ◽  
High Volume ◽  
Cement Leakage ◽  
Pedicle Screw Fixation ◽  
Screw Loosening ◽  
Pedicle Screw Placement ◽  
Screw Augmentation ◽  
Cement Embolism

OBJECTIVE Loosening and pullout of pedicle screws are well-known problems in pedicle screw fixation surgery. Augmentation of pedicle screws with bone cement, first described as early as 1975, increases the pedicle-screw interface and pullout force in osteoporotic vertebrae. The aim of the present study was to identify cement leakage and pulmonary embolism rates in a large prospective single-center series of pedicle screw augmentations. METHODS All patients who underwent cement-augmented pedicle screw placement between May 2006 and October 2010 at the authors' institution were included in this prospective cohort study. Perivertebral cement leakage and pulmonary cement embolism were evaluated with a CT scan of the area of operation and with a radiograph of the chest, respectively. RESULTS A total of 98 patients underwent placement of cement-augmented pedicle screws; 474 augmented screws were inserted in 237 vertebrae. No symptomatic perivertebral cement leakage or symptomatic pulmonary cement embolism was observed, but asymptomatic perivertebral cement leakage was seen in 88 patients (93.6%) and in 165 augmented vertebrae (73.3%). Cement leakage most often occurred in the perivertebral venous system. Clinically asymptomatic pulmonary cement embolism was found in 4 patients (4.1%). CONCLUSIONS Perivertebral cement leakage often occurs in pedicle screw augmentation, but in most cases, it is clinically asymptomatic. Cement augmentation should be performed under continuous fluoroscopy to avoid high-volume leakage. Alternative strategies, such as use of expandable screws, should be examined in more detail for patients at high risk of screw loosening.

scholarly journals Pedicle screw augmentation with bone cement enforced Vicryl mesh

2017 ◽  
Author(s):  
Samuel L. Schmid ◽  
Elias Bachmann ◽  
Michael Fischer ◽  
Dominik C. Meyer ◽  
Christoph A. Gerber ◽  
...  
Keyword(s):  
Bone Cement ◽  
Pedicle Screw ◽  
Screw Augmentation ◽  
Vicryl Mesh

Experimental Assessment of Modified Transpedicular Screw Augmentation with Polymethylmethacrylate (PMMA) for Pedicle Screw Loosening

2011 ◽  
Vol 11 (10) ◽  
pp. S125-S126
Author(s):  
Suk-Hyung Kang ◽  
Seung Won Park ◽  
Young-Baeg Kim ◽  
Yong-Jun Cho ◽  
Sung Youn Cho ◽  
...  
Keyword(s):  
Pedicle Screw ◽  
Screw Loosening ◽  
Experimental Assessment ◽  
Screw Augmentation ◽  
Transpedicular Screw ◽  
Pedicle Screw Loosening

Comparative Assessment of Sacral Screw Loosening Augmented with PMMA Versus a Calcium Triglyceride Bone Cement

Spine ◽  
2011 ◽  
Vol 36 (11) ◽  
pp. E699-E704 ◽  
Author(s):  
Stewart D. McLachlin ◽  
Khalid Al Saleh ◽  
Kevin R. Gurr ◽  
Stewart I. Bailey ◽  
Chris S. Bailey ◽  
...  
Keyword(s):  
Bone Cement ◽  
Comparative Assessment ◽  
Screw Loosening

The effect of application time of two types of bone cement on the cement–bone interface strength

2014 ◽  
Vol 25 (4) ◽  
pp. 775-781 ◽  
Author(s):  
Ziad Dahabreh ◽  
Hannah Kalpana Phillips ◽  
Todd Stewart ◽  
Martin Stone
Keyword(s):  
Bone Cement ◽  
Interface Strength ◽  
Application Time ◽  
Bone Interface

scholarly journals Can cavity-based pedicle screw augmentation decrease screw loosening? A biomechanical in vitro study

2020 ◽  
Author(s):  
Hans-Joachim Riesner ◽  
Thomas R. Blattert ◽  
Renate Krezdorn ◽  
Simone Schädler ◽  
Hans-Joachim Wilke
Keyword(s):  
Cyclic Loading ◽  
Pedicle Screw ◽  
Pedicle Screws ◽  
In Vitro Study ◽  
Complex Loading ◽  
Control Group ◽  
Slight Reduction ◽  
Screw Loosening ◽  
Screw Augmentation

Abstract Purpose In an osteoporotic vertebral body, cement-augmented pedicle screw fixation could possibly be optimized by the creation of an initial cavity. The aim of this study is to compare three test groups with regard to their loosening characteristics under cyclic loading. Methods Eighteen human, osteoporotic spine segments were divided in three groups. Flexibility tests and cyclic loading tests were performed with an internal fixator. The screws were fixed after creation a cavity and with cement (cavity-augmented group), without cavity and with cement (augmented group), and without cavity and without cement (control group). Cyclic loading up to 100,000 cycles was applied with a complex loading protocol. Screw loosening was measured with flexibility tests after implantation and after cyclic loading. Cement distribution was visualized from CT scans. Results In all groups, range of motion increased during cyclic loading, representing significant screw loosening after 100,000 cycles. In both augmented groups, screw loosening was less pronounced than in the control group. The cavity-augmented group showed only a slight tendency of screw loosening, but with smaller variations compared to both other groups. This may be explained with a trend for a more equal and homogeneous cement volume around each tip for the cavity-augmented group. Conclusion This study demonstrated that creating a cavity may allow a more equal fixation of all pedicle screws with slight reduction of loosening. However, augmentation only through a cannulated screw is almost equivalent, if care is taken that enough cement volume can be pushed out around the tip of the screw.

scholarly journals Clinical Effects and Complications of Pedicle Screw Augmentation with Bone Cement: Comparison of Fenestrated Screw Augmentation and Vertebroplasty Augmentation

2020 ◽  
Vol 12 (2) ◽  
pp. 194 ◽  
Author(s):  
Jin Hak Kim ◽  
Dong Ki Ahn ◽  
Won Shik Shin ◽  
Myung Jin Kim ◽  
Ho Young Lee ◽  
...  
Keyword(s):  
Bone Cement ◽  
Pedicle Screw ◽  
Clinical Effects ◽  
Screw Augmentation
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