scholarly journals Risk-Factor Analysis of Disc and Facet Joint Degeneration After Inter-Segmental Pedicle Screw Fixation for Lumbar Spondylolysis

2021 ◽  
Author(s):  
Hao Meng ◽  
Yuan Gao ◽  
Peng Lu ◽  
Guang-Min Zhao ◽  
Zhi-Cheng Zhang ◽  
...  
Keyword(s):  
Regression Analysis ◽  
Risk Factor ◽  
Pedicle Screw ◽  
Facet Joint ◽  
Screw Fixation ◽  
Pedicle Screw Fixation ◽  
Bony Union ◽  
Joint Degeneration ◽  
Lumbar Spondylolysis ◽  
Facet Joint Degeneration

Abstract Background: To assess the effects of inter-segment pedicle screw fixation for the treatment of lumbar spondylolysis, and evaluate various risk factors potentially predicting the probability of disc and facet joint degeneration after instrumentation.Methods: The study included 54 male L5 spondylolysis patients who underwent pars repair and inter-segment fixation using pedicle screws. Bony union was evaluated using reconstruction images of computed tomography. Radiographic changes including the disc height, vertebral slip, facet joint and disc degeneration in the grade of adjacent and fixed segments were determined from before to final follow-up. Logistic regression analysis was performed to identify factors associated with the incidence of disc and facet joint degeneration.Results: Bony union was achieved in all cases. Logistic regression analysis revealed that duration of instrumentation of more than 15.5 months and 21.0 months were significant risk factor of the incidence of L4/5 and L5S1 facet degeneration, respectively. Conclusions: Inter-segmental pedicle screw fixation provides good surgical outcomes and good isthmic bony union rates in patients with lumbar spondylolysis. The duration of fixation was confirmed as a risk factor of facet joint degeneration. Once bony union is achieved, remove of the instruments should be recommended.

scholarly journals Study on clinical effects of pedicle screw combined with immobilized implantation bone by wirerope and hallow compression screw immobilization in treating spondylolysis of lumbar vertebra of multiple segments of adults

2020 ◽  
Vol 6 (3) ◽  
pp. 19
Author(s):  
Dongdong Zhao ◽  
Feng Li ◽  
Yao Wu ◽  
Xiaoyan Zhang
Keyword(s):  
Pedicle Screw ◽  
Screw Fixation ◽  
Pedicle Screw Fixation ◽  
Control Group ◽  
Clinical Effects ◽  
Observation Group ◽  
Intraoperative Blood Loss ◽  
Compression Screw ◽  
Lumbar Spondylolysis ◽  
Duration Of Surgery

Objective: To observe clinical effects of pedicle screw fixation combined with cable wires and bone graft and cannulated compression screws on adult multi-segment lumbar spondylolysis.Methods: 70 cases of patients with multi-segment lumbar spondylolysis were selected in our hospital. According to different surgical schemes, these patients were divided into the observation group (35 cases) and the control group (35 cases). The observation group received pedicle screw fixation combined with cable wires and bone graft and the control group received cannulated compression screw fixation. Macnab criteria were adopted to implement a therapeutic evaluation of two groups of patients to make an observation and comparison of the excellent and good rate of surgery and a series of indicators including perioperative clinical effects, intraoperative blood loss, duration of surgery, hospital length of stay (HLOS), visual analogue scale (VAS), Oswestry disability index and Japanese Orthopaedic Association (JOA) score.Results: The excellent and good rate of the observation group was 97.14%, and that of the control group was 82.86%, the difference between two groups was statistically significant (χ2 = 6.248, p = .012). The differences in intraoperative blood loss, duration of surgery and HLOS between two groups were statistically significant (t = -4.55, t = -4.55, t = -4.55; p < .05). Oswestry index, VAS score and JOA score of the observation group were (2.4 ± 0.9), (28.5 ± 6.4) and (27.1 ± 3.1) respectively, and these of the control group were (3.5 ± 1.2), (37.1 ± 7.8) and (21.3 ± 2.7) respectively, the differences between two groups were statistically significant (t = 4.338, t = 5.043, t = 8.347, p < .05).Conclusions: Pedicle screw combined with immobilized implantation bone by wirerope has an excellent clinical effect on the treatment of adult multi-segment lumbar spondylolysis, and it has a series of advantages such as fast postoperative recovery, small surgical trauma and so on. In addition, this technique can also restore the stability of spinal segments and relieve pains to a greater degree.

scholarly journals Degenerative facet joint changes in lumbar percutaneous pedicle screw fixation without fusion

2015 ◽  
Vol 101 (3) ◽  
pp. 375-379 ◽  
Author(s):  
L. Proietti ◽  
L. Scaramuzzo ◽  
G.R. Schirò ◽  
S. Sessa ◽  
F.C. Tamburrelli ◽  
...  
Keyword(s):  
Pedicle Screw ◽  
Facet Joint ◽  
Screw Fixation ◽  
Pedicle Screw Fixation ◽  
Percutaneous Pedicle Screw ◽  
Percutaneous Pedicle Screw Fixation

scholarly journals Computed tomography Hounsfield unit–based prediction of pedicle screw loosening after surgery for degenerative lumbar spine disease

2020 ◽  
Vol 32 (5) ◽  
pp. 716-721
Author(s):  
Da Zou ◽  
Aikeremujiang Muheremu ◽  
Zhuoran Sun ◽  
Woquan Zhong ◽  
Shuai Jiang ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Regression Analysis ◽  
Pedicle Screw ◽  
Screw Fixation ◽  
Hounsfield Unit ◽  
Pedicle Screw Fixation ◽  
Screw Loosening ◽  
Pedicle Screw Loosening ◽  
Spine Disease ◽  
Lumbar Pedicle

OBJECTIVEThe authors investigated the relation between Hounsfield unit (HU) values measured on CT and the risk of pedicle screw loosening in patients who underwent lumbar pedicle screw fixation for degenerative lumbar spine disease.METHODSPatients who were treated with lumbar pedicle screw fixation between July 2011 and December 2015 at the authors’ department were reviewed. Age, sex, BMI, smoking and diabetes histories, range of fixation, and fusion method were recorded as the basic patient information. The HU values for lumbar bone mineral density (BMD) for the L1, L2, L3, and L4 vertebra were measured on CT scans. Logistic regression analysis was used to identify the independent influencing factors of pedicle screw loosening.RESULTSA total of 503 patients were included in the final analysis. The pedicle screw loosening rate at the 12-month follow-up was 30.0% (151 of 503 patients). There were no significant differences in sex, BMI, or histories of smoking and diabetes between the patients with (loosening group) and those without (nonloosening group) screw loosening (p > 0.05). The mean HU value of L1–4 was lower in the loosening group than the nonloosening group (106.3 ± 33.9 vs 132.6 ± 42.9, p < 0.001). In logistic regression analysis, being male (OR 2.065; 95% CI 1.242–3.433), HU value (OR 0.977; 95% CI 0.970–0.985), length of fixation (OR 3.616; 95% CI 2.617–4.996), and fixation to S1 (OR 1.699; 95% CI 1.039–2.777) were the independent influencing factors for screw loosening.CONCLUSIONSHU value measured on CT was an independent predictor for pedicle screw loosening, and lower HU value was significantly correlated with higher risk of screw loosening.

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