A Clinical Result of Pedicle Screw Fixation in Osteoporotic Spine - Complications and Prevention - (골다공증성 척추에서 척추경 나사못 고정력과 연관된 임상적 결과 - 합병증 및 예방 -)

김응하; 송현석; 김창근

A Clinical Result of Pedicle Screw Fixation in Osteoporotic Spine - Complications and Prevention -

Journal of Korean Society of Spine Surgery
Abbr : J Kor Spine Sur
2012, 19(4), pp.131-137
Publisher : Korean Society Of Spine Surgery
Research Area : Medicine and Pharmacy > Orthopedic Surgery

김응하 ¹, 송현석 ¹, 김창근 ²

¹순천향대학교
²순천향대학교 의과대학 정형외과학교실

Accredited

ABSTRACT

Study Design: Retrospective study. Objectives: To analyze the clinical results of patients who were treated by pedicle screw fixation in osteoporotic spine and suggest the methods for preventing a loss of fixation strength. Summary of Literature Review: There are some methods to decrease failure rate and increase fixation strength in the osteoporotic spine: use bicortical screw, cement augmentation and supporting anterior column by interbody fusion using cages. Materials and Methods: Forty-four patients treated by spinal instrumentation using pedicle screw from 2004 to 2011 were followed for at least 12 months. Five men and 39 women were diagnosed as osteoporotic spine (T score <-3.0). Two hundred forty eight pedicle screws were included and statistically analyzed the correlation between the use of bicortical screw, cement augmentation, anterior column support and fixation loss of the pedicle screw. Radiologic results were evaluated to find out the mechanical complications, like loosening of the screw, fixation failure, and nonunion. Results: There were 9 complications associated with mechanical strength, loosening of pedicle screws in 7, sinking down of cage in 4, and nonunion in 4 cases. Using bicortical pedicle screw, cement augmentation and anterior column support were significantly correlated with the increasing fixation strength (P=0.001, P=0.047, P=0.014). In addition, these three factors contribute to stabilize the instrumentation (Linear by linear association, P=0.012). Conclusions: These 3 methods, using bicortical pedicle screw, cement augmentation and supporting anterior column, are effective to enhance the fixation strength and prevent loss of holding power in the osteoporotic spine.

KEYWORDS

Osteoporosis, Pedicle screw, Fixation strength

Citation status

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

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