Pullout characteristics of percutaneous pedicle screws with different cement augmentation methods in elderly spines: An in vitro biomechanical study

Charles, Yann Philippe; Pelletier, Hervé; Hydier, Priscilla; Schuller, S.; Garnon, Julien; Sauleau, Erik-André; Steib, Jean-Paul; Clavert, Philippe

doi:10.1016/j.otsr.2015.01.005

Cited by 29 publications

(24 citation statements)

References 25 publications

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“…While most of such studies documented that PMMA augmentation enhanced pullout strength, 1,[9][10][11][12][13][14][15] the mechanism of screw loosening is a complex interaction of various loading patterns in vivo. 10) Furthermore, lifestyle, muscle strength, and sagittal or coronal balance may also be associated. Thus, the application of PMMA augmentation would bring about unexpected situations in vivo, which we assumed to be different according to the augmentation method in this study.…”

Section: Discussionmentioning

confidence: 99%

“…If PMMA mass is located near the tip of a screw, the pullout strength will not increase significantly compared to the use of a conventional unaugmented screw. 10,14) The measured values of strength are variable with a wide range because it is not easy to control the distribution of PMMA constantly. On the other hand, in the II-F method, the fixation strength is proportionally influenced by the number of fenestrations.…”

Section: Discussionmentioning

confidence: 99%

“…11) In the studies that reported the inferiority of the II-F method, the screws used had either 17) or two fenestrations. 11) The most serious problem with the II-F method is vertebral body fractures that can occur when an augmented screw is pulled out, 10,20,21) which could also result in neurological damage. The II-S group in our study had a higher rate of screw loosening and it seemed to be related not only to the anterior location of PMMA mass but also to the crack of PMMA mass (Fig.…”

Section: Discussionmentioning

confidence: 99%

“…a pedicle screw, bone cement polymethyl methacrylate (PMMA) augmentation was experimentally proved as the most efficacious option. [1][2][3][4][5][6][7][8] Most previous experimental studies examined only the pullout strength, 1,[9][10][11][12][13][14][15] while screw loosening in real clinical settings involves far more complicated mechanisms. Besides, there has been no study that documents the threshold of force required to prevent screw loosening in various conditions that are affected by the degree of osteoporosis, magnitude and location of deformity, and lifestyle.…”

mentioning

confidence: 99%

See 3 more Smart Citations

Clinical Effects and Complications of Pedicle Screw Augmentation with Bone Cement: Comparison of Fenestrated Screw Augmentation and Vertebroplasty Augmentation

Kim¹,

Ahn²,

Shin³

et al. 2020

Clin Orthop Surg

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show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

See 2 more Smart Citations

Clinical Effects and Complications of Pedicle Screw Augmentation with Bone Cement: Comparison of Fenestrated Screw Augmentation and Vertebroplasty Augmentation

Kim¹,

Ahn²,

Shin³

et al. 2020

Clin Orthop Surg

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show abstract

“…Thus, a surgeon dealing with a fracture in DISH must give extra attention to the screw placement to avoid intraoperative screw loosening. To obtain better bone purchase, cement augmentation 29,30 or grove entry technique 31 may be used in the patient with poor bone quality.…”

Section: Discussionmentioning

confidence: 99%

Spinal fractures in diffuse idiopathic skeletal hyperostosis: Advantages of percutaneous pedicle screw fixation

Okada

Shiono

Nishida

et al. 2019

J Orthop Surg (Hong Kong)

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To validate the effectiveness of percutaneous pedicle screw (PPS) fixation for spinal fractures associated with diffuse idiopathic skeletal hyperostosis (DISH) by comparing surgical outcomes for PPS fixation and conventional open posterior fixation. Patients with DISH are vulnerable to unstable spinal fractures caused by trivial trauma, and these fractures have high rates of delayed paralysis, postoperative complications, and mortality. Methods: This retrospective study assessed surgical outcomes for 16 patients with DISH (12 men; mean age 76.1 + 9.4 years) who underwent PPS fixation for spinal fractures (pedicle screw (PS) group), and for a control group of 25 patients with DISH (18 men; mean age 77.9 + 9.9 years) who underwent conventional open fixation (O group) at our affiliated hospitals from 2007 to 2017. We evaluated the preoperative physical condition (American Society of Anesthesiologists (ASA) classification), neurological status (Frankel grade), and improvement after surgery, fusion length, operating time, estimated blood loss, and perioperative complications. Results: Preoperatively, the PS group consisted of one ASA-1 patient, eight ASA-2 patients, six ASA-3 patients, and one ASA-4 patient; by Frankel grade, there were 2 grade B patients, 13 grade C, 4 grade D, and 6 grade E patients. The O group had 2 ASA-1 patients, 13 ASA-2, 9 ASA-3, and 1 ASA-4 patients. Frankel grades in the O group reflected severe neurological deficits, with 3 grade C patients, 2 grade D, and 11 grade E (p ¼ 0.032) patients. The two groups had similar rates of neurological improvement (33.3% of PS and 40.0% of O patients; p ¼ 0.410) and mean fusion length (PS 5.1 + 0.8 segments; O 4.9 + 1.2). The mean operating time and estimated blood loss were 168.1 + 46.7 min and 133.9 + 116.5 g, respectively, in the PS group, and 224.6 + 49.8 min and 499.9 + 368.5 g in the O group. Three O-group patients died of hypovolemic shock, respiratory failure, and pneumonia, respectively, within a year of surgery. Conclusion: Conventional open posterior fixation and PPS fixation for DISH-related spinal fractures were similar in fusion length and neurological improvement. However, PPS fixation was less invasive and had lower complication rates.

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Bone union‐promoting effect of romosozumab in an ovariectomized rat posterolateral lumbar fusion model

Okuyama,

Inage,

Kim

et al. 2024

Journal Orthopaedic Research

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Spinal fixation surgery has been increasingly performed in patients with osteoporosis. Romosozumab, a drug that was introduced in Japan recently, is known to possibly promote bone healing. However, few studies have reported the therapeutic effects of romosozumab in clinical practice in Japan. Therefore, here, we investigated the effects of romosozumab dosage on bone fusion promotion using an ovariectomized rat spinal fusion model. Eight‐week‐old female Sprague‐Dawley rats were matched by body weight and divided into three groups: 1.0 romosozumab (R) group (Evenity®, 25 mg/kg), 1/10R group (Evenity®, 2.5 mg/kg), and control (C) group (saline). Subcutaneous injections were administered twice a week for 8 weeks postoperatively. Computed tomography scans were performed every 2 weeks from the time of surgery till 8 weeks postoperatively. The mean fusion rates in terms of volume were significantly higher in the R groups [1/10R, 1.0R] than in the C group from 4 weeks postoperatively. The rate of increase was significantly higher in the 1.0R group from 4 weeks postoperatively and in the 1/10R group from 6 weeks postoperatively, than in the C group. The proportion of trabecular bone area was approximately 1.5 times higher in the R groups than in the C group. No significant differences were observed between the R groups. Our results suggest that romosozumab stimulates bone growth at the graft site, and similar effects were achieved at 1/10 of the standard dosage.

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Pullout characteristics of percutaneous pedicle screws with different cement augmentation methods in elderly spines: An in vitro biomechanical study

Cited by 29 publications

References 25 publications

Clinical Effects and Complications of Pedicle Screw Augmentation with Bone Cement: Comparison of Fenestrated Screw Augmentation and Vertebroplasty Augmentation

Clinical Effects and Complications of Pedicle Screw Augmentation with Bone Cement: Comparison of Fenestrated Screw Augmentation and Vertebroplasty Augmentation

Spinal fractures in diffuse idiopathic skeletal hyperostosis: Advantages of percutaneous pedicle screw fixation

Bone union‐promoting effect of romosozumab in an ovariectomized rat posterolateral lumbar fusion model

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