Posterior Screw Fixation in Beforehand Augmented Vertebrae with Bone Cement: Is It Inapplicable?
J Korean Neurosurg Soc. 2018 Jan;61(1):114-119
Authors: Park JH, Ju CI, Kim SW
Goal: The aim of this examine was to find out the feasibility of screw fixation in beforehand augmented vertebrae with bone cement. We additionally investigated the affect of cement distribution sample on the surgical approach.
Strategies: Fourteen sufferers who required screw fixation on the stage of the earlier percutaneous vertebroplasty or balloon kyphoplasty have been enrolled on this examine. The indications for screw fixation within the beforehand augmented vertebrae with bone cement included delayed problems, reminiscent of cement dislodgement, cement leakage with neurologic deficits, and varied degenerative spinal ailments, reminiscent of spondylolisthesis or foraminal stenosis. Scientific outcomes, together with ache scale scores, cement distribution sample, and procedure-related problems have been assessed.
Outcomes: Three sufferers underwent posterior screw fixation in beforehand cemented vertebrae as a consequence of cement dislodgement or progressive kyphosis. Three sufferers required posterior screw fixation for cement leakage or displacement of fracture fragments with neurologic deficits. Eight sufferers underwent posterior screw fixation as a consequence of varied degenerative spinal ailments. It was doable to insert screws within the beforehand augmented vertebrae whatever the cement distribution sample; nonetheless, screw insertion was tougher and adjusted instructions within the sufferers with cemented vertebrae exhibiting a strong sample moderately than a trabecular sample. All sufferers confirmed important enhancements in ache in contrast with the preoperative ranges, and no affected person skilled neurologic deterioration as seen on the ultimate follow-up.
Conclusion: For sufferers with vertebrae beforehand augmented with bone cement, posterior screw fixation is just not a contraindication, however is a possible possibility.
PMID: 29354243 [PubMed]