Chinese Journal of Tissue Engineering Research ›› 2011, Vol. 15 ›› Issue (48): 8993-8997.doi: 10.3969/j.issn.1673-8225.2011.48.016

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Biomechanical effects of kyphoplasty-assisted versus traditional bone cement augmentation on the loosened sacral screws

Zhou Dong-chang1, Wang Li-bing2, Zeng Li-wen2, Huang Yang-liang2, Yu Bin-sheng2   

  1. 1Department of Orthopaedics, Sanhe Hospital of Huiyang, Huizhou  516211, Guangdong Province, China
    2Department of Spinal Surgery, First Affiliated Hospital of Sun Yat-sen University, Guangzhou  510700, Guangdong Province, China
  • Received:2011-07-04 Revised:2011-09-24 Online:2011-11-26 Published:2011-11-26
  • Contact: Yu Bin-sheng, Professor, Chief physician, Department of Spinal Surgery, First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510700, Guangdong Province, China hpyubinsheng@hotmail.com
  • About author:Zhou Dong-chang, Attending physician, Department of Orthopaedics, Sanhe Hospital of Huiyang, Huizhou 516211, Guangdong Province, China 845667907@qq.com
  • Supported by:

    the Science and Technology International Cooperation Program of Guangdong Province, No. 2009B050700023*

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Abstract:

BACKGROUND: Kyphoplasty-assisted bone cement augmentation can be used in lumbar pedicle screw fixation of osteoporotic patients.
OBJECTIVE: To assess the fixation strengths of loosened sacral screws augmented with kyphoplasty-assisted and traditional bone cement techniques.
METHODS: Fresh sacra were harvested from nine osteoporotic cadavers. After testing bilaterally placed unicortical and bicortical pedicle screws, two unicortical pedicle screws with the traditional and kyphoplasty-assisted cement augmentations were established on the same sacrum. Following 2000 cyclic compression loading to screw head on a MTS machine, their maximum pull-out forces were recorded and compared.
RESULTS AND CONCLUSION: The bone mineral densities of nine specimens were ranged from 0.61 to 0.77 g/cm2 (0.71 g/cm2 in average). The mean maximum pull-out forces of unicortical and bicortical screws, and traditional and kyphoplasty-assisted cement screws were 203, 325, 437, and 565 N, respectively. The pull-out force was significantly higher in bicortical screw compared with unicortical (P < 0.05); however, these two fixations exhibited markedly lower pull-out strength compared with two cement augmentation techniques (P < 0.05). The pull-out strength was significantly higher in kyphoplasty-assisted cement augmentation group compared with traditional bone cement technique (P < 0.05). In addition, a significant positive correlation was exhibited between bone mineral density and pull-out force for the four fixations (P < 0.05). Results demonstrated that traditional and kyphoplasty-assisted cement augmentations can serve as the salvage technique for loosening sacral screw. However, kyphoplasty-assisted augmentation can provide higher stability. 

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