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.

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.

Hounsfield unit of screw trajectory as a predictor of pedicle screw loosening after single level lumbar interbody fusion

2018 ◽  
Vol 23 (5) ◽  
pp. 734-738 ◽  
Author(s):  
Yusuke Sakai ◽  
Shota Takenaka ◽  
Yohei Matsuo ◽  
Hiroyasu Fujiwara ◽  
Hirotsugu Honda ◽  
...  
Keyword(s):  
Pedicle Screw ◽  
Interbody Fusion ◽  
Hounsfield Unit ◽  
Lumbar Interbody Fusion ◽  
Screw Loosening ◽  
Single Level ◽  
Pedicle Screw Loosening

Pedicle screw loosening is correlated to chronic subclinical deep implant infection: a retrospective database analysis

2018 ◽  
Vol 27 (10) ◽  
pp. 2529-2535 ◽  
Author(s):  
Lukas Leitner ◽  
Isabella Malaj ◽  
Patrick Sadoghi ◽  
Florian Amerstorfer ◽  
Mathias Glehr ◽  
...  
Keyword(s):  
Pedicle Screw ◽  
Screw Loosening ◽  
Database Analysis ◽  
Implant Infection ◽  
Retrospective Database Analysis ◽  
Pedicle Screw Loosening ◽  
Retrospective Database

scholarly journals Role of Adjunctive Clindamycin in β-lactam-treated Cases of Invasive Group A Streptococcal Bacteremia: A Propensity Score-matched Analysis from 134 US Hospitals

2017 ◽  
Vol 4 (suppl_1) ◽  
pp. S565-S566
Author(s):  
Sameer S Kadri ◽  
Ahmed Babiker ◽  
Yi Ling Lai ◽  
Xiaobai Li ◽  
Sadia Hussain ◽  
...  
Keyword(s):  
Propensity Score ◽  
Invasive Group ◽  
Group A

scholarly journals Symptomatic pulmonary cement embolism after pedicle screw polymethylmethacrylate cement augmentation: A case report and review

2020 ◽  
Vol 11 ◽  
pp. 18 ◽  
Author(s):  
Abolfazl Rahimizadeh ◽  
Valiollah Hassani ◽  
Housain Soufiani ◽  
Ava Rahimizadeh ◽  
Mona Karimi ◽  
...  
Keyword(s):  
Pulmonary Embolism ◽  
Pedicle Screw ◽  
Rare Complication ◽  
Cement Leakage ◽  
Cement Augmentation ◽  
Case Description ◽  
Pedicle Screw Placement ◽  
Failed Back Syndrome ◽  
High Incidence ◽  
Cement Embolism

Background: In osteoporotic patients, a useful technique for significantly enhancing the strength of a pedicle screw is augmentation with polymethylmethacrylate cement. However, a rare complication of this procedure is a symptomatic pulmonary cement embolism. Case Description: A pedicle screw cement augmentation was performed in a middle-aged female for the failed back syndrome. When she developed symptomatic pulmonary cement emboli, she was successfully managed with conservative measures, including anticoagulation. Conclusion: Despite the increased use of cement augmentation for pedicle screw placement and the relatively high incidence of cement leakage into the prevertebral venous system, symptomatic cement pulmonary embolism remains rare. The management of such symptomatic CPE should be evaluated and treated based on both the size and location of the embolism. Here, we presented this case while reviewing three symptomatic and four asymptomatic cases from the literature.

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