Clinical Significance of the Radiolucent Zone Around the Pedicle Screws in the Lumbar Degenerative Disease (퇴행성 요추 질환에서 척추경나사 주위 방사선 투과 영역의 임상적 의미)

곽종일; 김현준; 선상규; 이규열

Clinical Significance of the Radiolucent Zone Around the Pedicle Screws in the Lumbar Degenerative Disease

Journal of Korean Society of Spine Surgery
Abbr : J Kor Spine Sur
2009, 16(3), pp.202-209
Publisher : Korean Society Of Spine Surgery
Research Area : Medicine and Pharmacy > Orthopedic Surgery

곽종일 ¹, 김현준 ¹, 선상규 ¹, 이규열 ¹

¹동아대학교

Candidate

ABSTRACT

Study design: A retrospective study. Objective: To analyze the clinical significance of the radiolucent zones surrounding pedicle screws. Summary of Literature Review: Clear zones have been suggested in pseudoarthrosis and a loss of fixation. However, few reports have clearly described the long-term course and clinical significance of clear zones. Materials and Methods: The clear zones were evaluated in 399 patients with pedicle screw fixation after 6 months, 1 year, 2 years and 3 years. The patient was considered to be clear zone positive when 1 mm or greater circumferential lucency was confirmed around a screw on film from 2 or more directions. The time-course of the clear zones was examined with regard to age, number of levels fused, bone union, fusion method and reoperation. Results: After 6 months, clear zones were observed in 124 patients (31.1%) but the clear zone-positive rate decreased with time. Clear zones were observed in 89 patients(22.3%), 44 patients(11.0%) and 41 patients(10.3%) after 1 year, 2 years and 3 years, respectively. No new clear zones had developed after 6 months. At the final follow-up, pseudoarthrosis was observed in 12 patients(3.0%). Among them, 11 were clear zone-positive and 1 was clear zone-negative. There was a statistically significant relationship between the clear zone-positive rate and multi-levels, older age and nonunion during following up. In addition, there was a relatively lower clear zone-positive rate in posterolateral fusion combined with posterior lumbar interbody fusion than only posterolateral fusion. However, the difference between them was not statistically significant. Conclusion: The presence of clear zones does not always mean pseudoarthrosis but clear zones persisting for more than 2 years after surgery have a higher rate of pseudoarthrosis.

KEYWORDS

Degenerative lumbar disease, Pedicle screw, Radiolucent zone, Pseudoarthrosis

Citation status

* References for papers published after 2023 are currently being built.

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