A Novel Method for the Prediction of the Pedicle Screw Stability

Ishikawa, Kentaro; Toyone, Tomoaki; Shirahata, Toshiyuki; Kudo, Yoshifumi; Matsuoka, Akira; Maruyama, Hiroshi; Hayakawa, Chikara; Tani, Soji; Sekimizu, Masaya; Tsuchiya, Kiyoshi; Eguro, Takeshi; Oshita, Yusuke; Ozawa, Tomoyuki; Nakao, Yusuke; Sano, Shigeo; Nagai, Takashi; Kanzaki, Koji; Inagaki, Kenji

doi:10.1097/bsd.0000000000000703

Cited by 34 publications

(30 citation statements)

References 43 publications

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“…As the world's population is aging, the prevalence of chronic diseases has increased. Hence, research on various countermeasures against musculoskeletal diseases, which impair daily living and the quality of life, is urgently needed [1][2][3].…”

Section: Introductionmentioning

confidence: 99%

Risk factors predicting osteosarcopenia in postmenopausal women with osteoporosis: A retrospective study

et al. 2020

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There is growing interest in “osteosarcopenia” as the coexistence of osteoporosis and sarcopenia exacerbates negative outcomes. However, limited information is available regarding the risk factors of osteosarcopenia development in patients with osteoporosis. Therefore, we retrospectively reviewed 276 consecutive patients with postmenopausal osteoporosis who regularly visited Showa University Hospital. Patients were eligible for the study if they were ≥65 years of age and underwent dual-energy X-ray absorptiometry, blood sampling, and physical performance assessment. Patients were divided into the osteosarcopenia and osteoporosis alone groups according to the diagnostic criteria of the Asian Working Group for Sarcopenia. Of the 276 patients with osteoporosis, 54 patients (19.6%) had osteosarcopenia. Patients in the osteosarcopenia group had a greater risk of frailty than did those in the osteoporosis alone group (odds ratio 2.33; 95% confidence interval, 1.13–4.80, P = 0.028). Low body mass index seemed to be the strongest factor related to the development of osteosarcopenia, and none of the patients in the osteosarcopenia group were obese (BMI ≥27.5 kg/m 2 ). Multiple logistic analyses revealed that patients aged 65–74 years who had comorbidities such as kidney dysfunction and high levels of HbA1c were at risk of developing osteosarcopenia. Thus, we strongly recommend the assessment of the key components of the diagnosis of osteosarcopenia in an osteoporosis clinic for patients with low body mass index. Furthermore, appropriate assessments, including comorbidities, will help in identifying patients at greater risk of developing osteosarcopenia.

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Section: Introductionmentioning

confidence: 99%

Risk factors predicting osteosarcopenia in postmenopausal women with osteoporosis: A retrospective study

et al. 2020

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“…Therefore, the previous reports may have underestimated the effect of denosumab discontinuation. With QCT, bone strength can be evaluated and trabecular bone and cortical bone can be assessed separately in three dimensions, without the interference of the surrounding osteophytes 9,15,16. The magnitude of bone loss was greater in the femoral bone than in the LS, and the FN-BMD returned to the average baseline value.…”

Section: Discussionmentioning

confidence: 99%

<p>Analysis of three-dimensional bone mineral density and bone strength measured by quantitative computed tomography following denosumab discontinuation in a patient with postmenopausal osteoporosis</p>

Tsuchiya¹,

Ishikawa²,

Tani³

et al. 2019

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Discontinuation of denosumab during osteoporosis treatment leads to rapid loss of bone mineral density and induces a bone turnover rebound effect. Previous studies have reported analysis based on dual-energy X-ray absorptiometry scanning (DXA). Here, we report the first case involving analysis of three-dimensional bone mineral density and bone strength, measured by quantitative computed tomography (QCT) after discontinuation of denosumab. An 82-year-old woman who discontinued denosumab because of patient’s wish was administered the fifth dose after a gap of 14 months. Her bone mineral density evaluated by DXA and QCT, bone strength, and bone turnover marker levels showed significant rebound phenomenon. The levels of the cortical parameters of the hip were also decreased indicating an increased risk of femoral fractures after denosumab interruption. Our case highlights the increased risk of fractures after discontinuation of denosumab. Therefore, denosumab must be used judiciously without interruption in the dosage schedule.

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“…Numerous studies have proved that pedicle screw xation provided reliable stability for spinal segment to achieve safe and successful outcomes [4,5]. However, it showed the challenges in controlling the incidence of screw loosening which is between 0.6% and 11% and may cause the fusions to become unstable, especially for the aged population with osteoporosis [6][7][8]. Osteoporosis is characterized by low bone mineral density (BMD) and deterioration of bone microarchitecture, which can affect quality of life dramatically for patients and still have high di culties and increased risk for surgery.…”

Section: Introductionmentioning

confidence: 99%

Pullout strength of adjusting pedicle screw with or without self-bone grafting in the previous trajectory using an osteoporotic human vertebral body

Liu¹,

Li²,

Gao³

et al. 2020

Preprint

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Objectives The aim of this study is to explore the pullout strength of adjusting pedicle screw with or without self-bone grafting in the previous trajectory using an osteoporotic human vertebral body. Methods Thirty vertebrae from six cadavers were collected and all of the vertebrae were divided into two groups according to bone mineral density: control group with normal bone mineral density; osteoporosis group with osteoporosis. The osteoporosis group was randomly and evenly divided into five subsamples according to direction of reinsert pedicle screw: the normal angle, sagittal angle, sagittal bone grafting, horizontal angle, horizontal bone grafting. Axial pullout strength testing of the pedicle screw was performed and the maximum axial pullout force (Fmax) was applied to analyse. Result The bone mineral density of the control group was 1.115±0.065 g/cm3, and the bone mineral density of the osteoporosis group was 0.678±0.055 g/cm3, presenting significantly different between the two group (P<0.001). Compared with the control group, the Fmax of the normal angle group was smaller (600.64±43.10 vs 1100.74±49.08 N, P<0.001). Compared with the normal angle group, the Fmax of the sagittal angle group (339.13±38.90 vs 600.64±43.10 N, P<0.001) and the horizontal angle group (342.06±33.01 vs 600.64±43.10 N, P<0.001) were smaller. The Fmax in sagittal bone grafting group was higher than that with non-implanted bone in primary screw canal (492.30±42.06 vs 342.06±33.01 N, P<0.001), and the Fmax of the horizontal bone grafting group was higher than that with non-implanted bone in primary screw canal (502.02± 50.26 vs 342.06±33.01 N, P<0.001). Conclusion The pullout strength of adjusting pedicle screw is seriously decreased in osteoporotic human vertebral body and self-bone grafting in the previous trajectory is an effective remedial measure.

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A Novel Method for the Prediction of the Pedicle Screw Stability

Abstract: The preoperative measurement of PS-vBMD was technically feasible and reliably predictive of screw insertional torque during transpedicular fixation in a clinical setting.

Cited by 34 publications

References 43 publications

Risk factors predicting osteosarcopenia in postmenopausal women with osteoporosis: A retrospective study

Risk factors predicting osteosarcopenia in postmenopausal women with osteoporosis: A retrospective study

<p>Analysis of three-dimensional bone mineral density and bone strength measured by quantitative computed tomography following denosumab discontinuation in a patient with postmenopausal osteoporosis</p>

Pullout strength of adjusting pedicle screw with or without self-bone grafting in the previous trajectory using an osteoporotic human vertebral body

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