Affect of Hydroxyapatite Stick on Pedicle Screw Fixation in Degenerative Lumbar Backbone: Biomechanical and Radiologic Research.
Clin Backbone Surg. 2017 Jul;30(6):E819-E826
Authors: Shin SJ, Lee JH, Lee JH
STUDY DESIGN: A potential, within-patient, left-right comparative research.
OBJECTIVE: To judge the efficacy of hydroxyapatite (HA) stick augmentation methodology by evaluating the insertional torque of the pedicle screw in osteoporotic and nonosteoporotic sufferers.
SUMMARY OF BACKGROUND DATA: Unsatisfactory scientific outcomes after backbone surgical procedure in osteoporotic sufferers are associated to pedicle screw loosening or pull-outs. HA, as a bone graft extender, has a chance to boost the fixation power on the bone-screw interface.
METHODS: From November 2009 to December 2010, amongst sufferers who required bilateral pedicle screw fixation for lumbar backbone surgical procedure, 22 sufferers have been enrolled, who recieved unilateral HA stick augmentation and accomplished intraoperative insertional torque measurement of every pedicle screws. On the premise of preoperative analysis of bone mineral density, sufferers with osteoporosis had 2 HA sticks inserted unilaterally, and 1 stick for sufferers with out osteoporosis. Pedicle screw loosening and pull-outs have been assessed utilizing 12-month postoperative CT scans and follow-up radiographs. Scientific analysis was completed preoperatively and at 1 12 months postoperatively, primarily based on Visible Analog Scale rating, Oswestry Incapacity Index, and Brief Type-36 Well being Survey.
RESULTS: No matter bone mineral density, the common torque worth of all pedicle screws with HA stick insertion (HA stick inserted group) was considerably increased than that of all pedicle screws with out HA insertion (management group) (P<zero.0001). Similar outcomes have been seen within the HA stick inserted subgroups and the management subgroups inside each of the osteoporosis group (P=zero.009) and the nonosteoporosis group (P=zero.0004). There was no statistically vital distinction of the speed of pedicle screw loosening in between the HA stick inserted group and the management group. Scientific analysis additionally confirmed no statistically vital distinction in between sufferers with loosening and people with out.
CONCLUSIONS: The enhancement of preliminary pedicle screw fixation power in osteoporotic sufferers may be achieved by HA stick augmentation.
PMID: 27352365 [PubMed – indexed for MEDLINE]