Inserting pedicle screws in lumbar spondylolisthesis – The easy bone conserving way

Lal, Hitesh; Kumar, Lalit; Kumar, Ramesh; Boruah, Tankeshwar; Jindal, Pankaj; Sabharwal, Vinod Kumar

doi:10.1016/j.jcot.2016.11.010

Cited by 7 publications

(4 citation statements)

References 32 publications

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“…It is difficult for osteoporotic vertebrae to provide good pullout strength for pedicle screws due to the loss of bone mass and sparse bone trabeculae. Due to vertebral body forwards sliding and rotation, lumbar-pelvic sagittal imbalance and intervertebral instability 16 , 17 , the pullout strength of pedicle screws must be higher than that of pedicle screws during surgery, especially in isthmic spondylolisthesis. Biomechanical studies confirmed that the pullout strength of the pedicle screw was significantly reduced when the bone density was less than 0.777 ± 0.330 g/cm 2 20 .…”

Section: Discussionmentioning

confidence: 99%

“…Isthmic spondylolisthesis is a common spinal disease that requires a higher holding power of screws due to poor spinal stability and the need for pull-up and reduction during surgery 16 , 17 . Previous studies have reported that PMMA-PSs enhance the holding power of the screws 14 , but few cases have reported their use in single-segment isthmic spondylolisthesis in osteoporotic patients.…”

Section: Introductionmentioning

confidence: 99%

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Comparison of pedicle screw fixation with or without cement augmentation for treating single-segment isthmic spondylolisthesis in the osteoporotic spine

Peng

Guo

Zhan

et al. 2023

Sci Rep

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The present study examined the necessity of cement-augmented pedicle screw fixation in osteoporotic patients with single-segment isthmic spondylolisthesis.Fifty-nine cases were reviewed retrospectively. Thirty-three cases were in the polymethylmethacrylate-augmented pedicle screw (PMMA-PS) group, and the other 26 cases were in the conventional pedicle screw (CPS) group. Evaluation data included operation time, intraoperative blood loss, hospitalization cost, hospitalization days, rates of fusion, screw loosening, bone cement leakage, visual analogue scale (VAS) scores, Oswestry disability index (ODI), lumbar lordosis (LL), pelvic tilt (PT) and sacral slope (SS).The operation time and blood loss in the CPS group decreased significantly compared to those in the PMMA-PS group. The average hospitalization cost of the PMMA-PS group was significantly higher than that of the CPS group. There was no significant difference in the average hospital stay between the 2 groups. The initial and last follow-up postoperative VAS and ODI scores improved significantly in the two groups. There were no significant differences in VAS and ODI between the 2 groups at each time point. The last postoperative spine-pelvic parameters were significantly improved compared with those preoperatively. In the PMMA-PS group, the fusion rate was 100%. The fusion rate was 96.15% in the CPS group. No significant difference was found between the two groups for the fusion rate. Nine patients in the PMMA-PS group had bone cement leakage. There was no screw loosening in the PMMA-PS group. There were 2 cases of screw loosening in the CPS group. There were no significant differences in screw loosening, postoperative adjacent segment fractures, postoperative infection or postoperative revision between the 2 groups. The use of PMMA-PS on a regular basis is not recommended in posterior lumbar interbody fusion for the treatment of single-segment isthmic spondylolisthesis with osteoporosis.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Comparison of pedicle screw fixation with or without cement augmentation for treating single-segment isthmic spondylolisthesis in the osteoporotic spine

Peng

Guo

Zhan

et al. 2023

Sci Rep

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“…Spondylolisthesis, a complex and challenging multifactorial condition, shows forwards slippage of one vertebra over another. It can occur at any age and one study shows the average age of 42 years [6]. It may occur both in male and female and one study shows a male to female ratio of 1.1:1 [7].…”

Section: Discussionmentioning

confidence: 99%

“…According to the pre-operative ODI score was 53.7 (±13.1) which improved to 22.5 SD 15.5 at two years follow-up [12]. The average pre-operative ODI score was 51.4, which improved to 18.6 postoperatively [6], but we have divided our patients into three groups with ODI score of 32.63 in moderate disability group while 67 in the group with crippling pain.…”

Section: Discussionmentioning

confidence: 99%

Surgical Outcome of Decompression and Fixation of Degenerative Lumbosacral Spondylolisthesis Surgery in Pakistani Population

Tahir

Rehman

Bokhari

et al. 2019

Cureus

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BackgroundSpondylolisthesis is characterized by the slipping of one vertebra, compared with the underlying one, due to structural and degenerative changes. Its origin is multifactorial which includes disc degeneration, facet joint anatomic orientation, iliolumbar configuration, and ligament hyperlaxity. The most common operative treatment is decompression and may require an individualized surgical plan. However, only decompression may progress the slippage which can result in pain or recurrence of neurological complaints. Therefore, lumbar fusion and fixation are considered appropriate to stabilise the spine and prevent delayed deterioration. The aim of our study was to find out the outcome of posterior decompression, with reduction and fixation of lumbosacral spondylolisthesis by Oswestry Disability Index (ODI) to improve further our results.MethodsThis study was conducted from July 2013 to February 2017 including 94 patients with lumbosacral spondylolisthesis. The Meyerding classification was used to grade the extent of vertebral slippage. The assessment was done using the ODI.ResultsThere were 50 (53.19%) males and 54 (46.80%) females with a mean age of 44 years ± 10.49 SD. Backache was present in all patients and claudication in 85 (90.42%) patients. There were 10 (10.63%) patients with spondylolisthesis at L3-L4, 36 (38.29%) at L5-S1 and 48 patients (51.06%) at L4-L5 level. In 48 patients with L4-L5 level, 38 (79.16%) were in grade II while six (12.5%) were in grade III. According to the preoperative ODI score, 38 patients were placed in moderate disability, 42 patients were severely disabled while four patients were disabled.Good outcome was achieved in a total of 79 (84.04%) patients. In 40 (42.55%) patients, with complete reduction, the good outcome achieved in 35 (83.33%) while in 22 (23.40%) patients there was no reduction and a good outcome was achieved in 17 (77.27%) patients. In 38 (40.42%) patients with moderate disability, 32 (84.04%) patients had a good outcome. Post-operative cerebrospinal fluid (CSF) leak occurred in five (5.31%) and wound infection in seven (7.44%) patients while there was no mortality.ConclusionReduction with decompression can have a good outcome in spondylolisthesis, and ODI should be used as a predictor of outcome. It also shows that proper decompression is required and not a complete reduction.

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Role of Imaging Data in Additive Manufacturing for Biomedical Applications

Singh

Pandey

2020

Materials Horizons: From Nature to Nanomaterials

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Inserting pedicle screws in lumbar spondylolisthesis – The easy bone conserving way

Abstract: Our surgical technique used for high grade spondylolisthesis is safe, cost-effective, bone-preserving, reliable, and reproducible for high grade Lumber spondylolisthesis.

Cited by 7 publications

References 32 publications

Comparison of pedicle screw fixation with or without cement augmentation for treating single-segment isthmic spondylolisthesis in the osteoporotic spine

Comparison of pedicle screw fixation with or without cement augmentation for treating single-segment isthmic spondylolisthesis in the osteoporotic spine

Surgical Outcome of Decompression and Fixation of Degenerative Lumbosacral Spondylolisthesis Surgery in Pakistani Population

Role of Imaging Data in Additive Manufacturing for Biomedical Applications

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