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

2020 ◽  
Author(s):  
Guo-ye Mo ◽  
Teng-peng Zhou ◽  
Yong-xian Li ◽  
Hui-zhi Guo ◽  
Dan-qing Guo ◽  
...  

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.

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Guo-ye Mo ◽  
Teng-peng Zhou ◽  
Hui-zhi Guo ◽  
Yong-xian Li ◽  
Yong-chao Tang ◽  
...  

AbstractThis study aimed to evaluate the efficacy and safety of bone cement-augmented pedicle screw fixation for stage III Kümmell disease. 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. 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%). 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.


2021 ◽  
Author(s):  
Xiaofeng Shao ◽  
Peng Peng ◽  
Peng Yang ◽  
Tian Xu ◽  
Zixiang Liu ◽  
...  

Abstract Objective: To retrospectively analyze the short-term and long-term efficacy of O-arm-navigated percutaneous short segment pedicle screw fixation with or without screwing of the fractured vertebra.Methods: 42 patients who underwent O-arm-navigated percutaneous short segment pedicle screw fixation for the treatment of thoracolumbar fractures from February 2015 to December 2018 were selected. The patients were divided into two groups according to fixation with or without screwing of the fractured vertebra, 21 cases each. The operation time, length of incision and intraoperative bleeding of the two groups of patients, as well as preoperative, one-week postoperatively and one-year postoperatively Cobb angle, percentage of anterior vertebral height, VAS and ODI data were analyzed to compare the short-term and long-term clinical outcomes of the two groups.Results: All the patients underwent surgery successfully. There were no neurological or other complications after the surgery. All patients were followed up for at least one year. There was no failure of fixation at the one-year follow-up. There was no significant difference in the operation time and intraoperative blood loss between the two groups (P>0.05). The length of incision was statistically significantly different between the two groups (P<0.05). There was no significant difference in Cobb angle and AVH% between the two groups before and one week after the surgery (P>0.05). The Cobb angle and AVH% was statistically significantly different one year after the surgery between the two groups (P<0.05).The Cobb angle and AVH% contrast was statistically significant before surgery, one week and one year after the surgery in the respective group (P<0.05). There was no statistically significant difference in the VAS and ODI preoperatively, one-week and one-year postoperatively between the two groups (P>0.05). There was statistically significant difference in the VAS and ODI throughout the follow-up period in the respective group(P<0.05). Conclusion: The short-term efficacy of the two groups is similar, but the long-term efficacy is better through screwing of the fractured vertebra.


2016 ◽  
Vol 29 (2) ◽  
pp. 78-85 ◽  
Author(s):  
Haitao T. Fan ◽  
Renjie J. Zhang ◽  
Cailiang L. Shen ◽  
Fulong L. Dong ◽  
Yong Li ◽  
...  

2018 ◽  
Vol 24 ◽  
pp. 1072-1079 ◽  
Author(s):  
Yan-Sheng Huang ◽  
Ding-Jun Hao ◽  
Hang Feng ◽  
Hai-Ping Zhang ◽  
Si-Min He ◽  
...  

2017 ◽  
Vol 17 (6) ◽  
pp. 837-844 ◽  
Author(s):  
Insa Janssen ◽  
Yu-Mi Ryang ◽  
Jens Gempt ◽  
Stefanie Bette ◽  
Julia Gerhardt ◽  
...  

QJM ◽  
2020 ◽  
Vol 113 (Supplement_1) ◽  
Author(s):  
E E A Emara ◽  
S H Morad ◽  
A R Farghaly ◽  
O E Ahmed ◽  
M K Khalil

Abstract Background Lumbar interbody fusion is a recognized surgical technique in treatment of degenerative lumbar instability. Interbody fusion supplemented with pedicle screw fixation has several advantages over posterolateral fusion and has been advocated to improve fusion rates and clinical outcomes. Interbody fusion places the bone graft in the loadbearing position of the anterior and middle spinal columns thereby enhancing the potential for fusion. In addition, the interbody space has more vascularity than the posterolateral space, also increasing the potential for a solid fusion mass to form. Aim of the Work to assess safety and efficacy of unilateral pedicle screw fixation associated with interbody fusion in Lumbar spine degenerative diseases and to evaluate and compare outcomes of unilateral versus bilateral pedicle screw fixation associated with interbody fusion in lumbar spine degenerative diseases, as regard the operation time, bleeding, postoperative stay, cost, and the clinical and biomechanical results. Material & Methods This observational prospective comparative study of the 2 groups who were operated either unilateral (Group A /25 patients) or bilateral (Group B/25 patients) pedicle screw fixation with interbody fusion was done. Patients were followed up for 1, 6, 12 months. This study occurred at Ain Shams University hospitals. Results No differences were observed between the two groups with respect to demographic data. The patients of the two groups had significant improvement in functional outcome compared to preoperatively, except in early postoperative VAS back and ODI in unilateral group which is better than bilateral group. However, no significant difference noticed in the further follow up. There was no significant difference comparing fusion rate, complication rate and duration of hospital stay between the two groups at postoperative follow-up. There was significantly less blood loss, shorter postoperative pain killer use and significantly shorter operation time in the unilateral PS fixation group as compared with the bilateral PS fixation group in our study. Conclusion Our study suggested TLIF with unilateral PS fixation was as safe and effective as that with bilateral PS fixation. Unilateral PS fixation may significantly reduce the intraoperative blood loss and shorten the operation time, somewhat improve the clinical outcome scores of ODI and VAS Back without significant difference comparing fusion rate, complication rate and duration of hospital stay between the two groups at postoperative follow-up. BPSF with TLIF likely causes more degeneration at the cranial adjacent segment compared with UPSF techniques. However, the long-term follow up is required to demonstrate the impact of these findings.


2020 ◽  
Author(s):  
Chengxuan Tang ◽  
Xiaojun Tang ◽  
Yimin Li ◽  
Xiqiang Zhong ◽  
Weihao Zhang ◽  
...  

Abstract Background: Percutaneous mesh-container-plasty (PMCP) and pedicle screw fixation plus vertebroplasty (PSFV) were developed with advantages of bone cement leakage, height restoration and kyphotic angle reduction in osteoporotic vertebral compression fractures (OVBF). The purpose of the current study was to compare the effects and safety between PMCP and PSFV for treatment of thoracolumbar OVBF. Methods: A retrospective study of 227 consecutive patients with thoracolumbar OVBF without neurologic deficit who underwent PMCP (n=109) or PSFV (n=118) was conducted. The epidemiological data, surgical outcomes, clinical and radiological features were compared between the 2 groups. Clinical evaluation of VAS and ODI, and radiological evaluation of height restoration, deformity correction, cement leakages and canal compromise were calculated on preoperative, postoperative and 2 years postoperative.Results: Cost(4.82±0.21 vs. 5.50±0.29, P<0.05), blood loss(7.36±3.67 vs. 22.52±4.79, P<0.05), operation time(34.35±8.72 vs. 92.70±17.24, P<0.05) and hospital day(4.42±1.62 vs. 5.46±2.31, P<0.05) were significantly lower in the PMCP group than in the PSFV group. VAS [2(1,3) vs. 3(2.75,4), P<0.05] and ODI (21.01±7.90 vs. 33.81±8.81, P<0.05) scores were significantly lower in the PMCP group than in the PSFV group postoperative. However, no statistical difference was found in VAS and ODI between group PMCP and PSFV 2 years postoperative. Anterior(85.63±8.22% vs. 74.86±12.60%; 83.49±8.95% vs. 68.77±11.32%; P<0.05) and middle vertebral body height ratio(84.68±7.69% vs. 71.05±12.68%; 82.47±8.34% vs. 74.96±12.90%; P<0.05) were significantly higher in the PSFV group than in the PMCP group postoperative. Cobb angle(7.95±4.42 vs. 11.99±5.69, 8.59±4.46 vs. 12.95±5.74; P<0.05) and canal compromise(19.85±6.18 vs. 10.18±6.99, 10.03±7.20 vs. 19.90±5.98; P<0.05) were significantly lower in group PSFV than in the PMCP group postoperative. No statistical difference was found in cement leakage between group PMCP and PSFV. Conclusion: Despite of relative worse radiological results, PMCP is a safe, minimally invasive, and cost-effective surgical method and can obtain better satisfactory clinical results compared to PSFV for OVBF.


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