Improvement of pedicle screw stability in patients of osteoporosis / 中国矫形外科杂志

ABSTRACT

[Objective]To study the clinical results of methods of improvement of pedicle screw stability in patients of osteoporosis. [Method]Thirty-four cases of patients with osteoporosis were operated using pedicle screw and methods of improvement of pedicle screw stability were used during the operations.Of which,male 20,female 14;the mean age of 57(range 40～71).According to Jikei grading scale for osteoporosis,8 were of early stage,11 of stageⅠ,8 of stageⅡ and 7 of stageⅢ.There were 14 cases of fractures and 20 cases of osteopathy.For patients of early stage and stageⅠ(19 cases),long and large size of pedicle screws were used,meanwhile stiff connection rod system,two cross-link devices,placement of pedicle screw with large angles in horizontal and sagital planes were applied.For patients of stageⅡ and stageⅢ(15 cases) bone cement was used to fill the pedicle hole to ensure the screw stabily.[Result]There were no neurologic and vessel injuries or aggravated as well as no breakage of screw except two cases with loosening of screw during the follow-up with the mean period of 14 months(range 9～26).The loss of correction of reduction in fractures was 5%,the rate of fusion was 100% in grafting.[Conclusion]Different methods of improvement of pedicle screw stability used in osteoporosis may avoid loosening of screw and loss of correction.