Stability and interbody fusion of augmented pedicle screws with bone cement for lumbar spondylolisthesis accompanied with osteoporosis / 中国组织工程研究

ABSTRACT

BACKGROUND: In lumbar spondylolisthesis patients with severe osteoporosis, screw is easily loose and pul s out during reposition, or loss of reduction and internal fixation failure easily occur after repair. Therefore, it is very important to elevate the intensity of pedicle screw fixation during repair. At present, few studies concern application of bone cement screw enhancement technology in lumbar spondylolisthesis patients with osteoporosis. OBJECTIVE: To investigate the clinical value of augmented pedicle screw with polymethylmethacrylate for lumbar spondylolisthesis accompanied with osteoporosis. METHODS: From June 2009 to June 2011, 27 patients suffering from lumbar spondylolisthesis accompanied with osteoporosis were included in this retrospective study. These patients received augmented pedicle screw with polymethylmethacrylate. The levels of disability and pain were evaluated by Oswestry Disability Index and visual analog scale. The internal fixation and fusion were evaluated by radiological findings. Al complications were recorded. RESULTS AND CONCLUSION: Al cases were fol owed up for 15-37 months. Oswestry Disability Index and visual analog scale scores were significantly better in final fol ow-up than that pre-treatment (P < 0.05). Imaging results revealed that bone cement tightly connected to bone interface. The position of screw and bone cement was good. Symptomatic bone cement leakage was not found. No fixation failure was detected during final fol ow-up. Al patients achieved interbody fusion. These results suggested that polymethylmethacrylate bone cement could increase the gripping force of the pedicle screw in osteoporotic vertebral body. It is safe and effective to treat spondylolisthesis accompanied with osteoporosis with augmented pedicle screws. Satisfactory fixation stability and interbody fusion can be obtained.