Clinical efficacy of Bone Cement-injectable Cannulated Pedicle Screw Short Segment Fixation for Lumbar Spondylolisthesis with Osteoporosise

Yao-Yao Liu,Jun Xiao,Xiang Yin,Fei Dai,Peng Liu,Ming-Yong Liu,Jian-Hua Zhao

doi:10.1038/s41598-020-60980-w

Yao-Yao Liu, Jun Xiao + Show 5 more

Open Access

https://doi.org/10.1038/s41598-020-60980-w

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Journal: Scientific Reports	Publication Date: Mar 3, 2020
Citations: 18	License type: open-access

Affiliation: Southwest Hospital, Army Medical University

Abstract

Many clinical studies have shown a satisfactory clinical efficacy using bone cement-augmented pedicle screw in osteoporotic spine, however, few studies have involved the application of this type of screw in lumbar spondylolisthesis. This study aims to investigate the mid-term clinical outcome of bone cement-injectable cannulated pedicle screw (CICPS) in lumbar spondylolisthesis with osteoporosis. From 2011 to 2015, twenty-three patients with transforminal lumbar interbody fusion (TLIF) using CICPS for lumbar spondylolisthesis were enrolled in the study. Oswestry Disability Index (ODI) and Visual Analogue Scale (VAS) were used to evaluate faunctional recovery and physical pain; and operation time, blood loss and hospitalization time were recorded, respectively. Radiograph and computed tomography of lumbar spine was performed to assess loss of the intervertebral disc space height, fixation loosening, and the rate of bony fusion. The average follow-up time of 23 patients was 22.5 ± 10.2 months (range, 6–36 months). According to VAS and ODI scores, postoperative pain sensation and activity function were significantly improved (p < 0.05). The height of the intervertebral disc space was reduced by 0.4 ± 1.1 mm, and the bone graft fusion rate was 100%. No cases of internal fixation loosening or screw pullout was observed. CICPS using cement augmentation may suggest as a feasible surgical technique in osteoporotic patients with lumbar spondylolisthesis.

Highlights

Traditional methods to improve the stability of pedicle screw are as follows: (1) Increasing the length and diameter of the screws[2]; (2) Improving the screw design, such as expansion screw[3,4]; and (3) Using bone granules or bone cement such as polymethylmethacrylate (PMMA) to strengthen the screw tunnel[5,6,7]
To evaluate the results and feasibility of this technique, we retrospectively reviewed the data of 23 consecutive patients with lumbar spondylolisthesis treated with transforminal lumbar interbody fusion (TLIF) using cement-injectable cannulated pedicle screw (CICPS), and summarized the incidence of complications and the clinical efficacy of PMMA augmentation
From 2011 to 2015, consecutive 23 patients compriseing 9 males and 14 females with lumbar spondylolisthesis and osteoporosis were reviewed in the study

Summary

Introduction

Traditional methods to improve the stability of pedicle screw are as follows: (1) Increasing the length and diameter of the screws[2]; (2) Improving the screw design, such as expansion screw[3,4]; and (3) Using bone granules or bone cement such as polymethylmethacrylate (PMMA) to strengthen the screw tunnel[5,6,7]. To evaluate the results and feasibility of this technique, we retrospectively reviewed the data of 23 consecutive patients with lumbar spondylolisthesis treated with TLIF using CICPS, and summarized the incidence of complications and the clinical efficacy of PMMA augmentation. CICPS was designed as a hollow screw rod with three side holes for bone cement outflow at the tip.

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