Abstract:

BACKGROUND: The treatment of severe osteoporosis with lumbar degenerative diseases is difficult, vertebral body perfusion of bone cement could increase the stability of pedicle screw and spine.
OBJECTIVE: To explore the clinical effect of the bone cement augmentation of vertebral body to increase stability of pedical screw for the treatment of severe osteoporosis with lumbar diseases, and to analyze the technical parameters of bone cement infusion and the influence of the fixed segments.
METHODS: A total of 39 patients who suffered from osteoporosis with lumbar diseases and underwent posterior decompression and laminectomy were reviewed retrospectively. In surgical procedures the augmentation of vertebral body strength using bone cement and pedicle screw fixation were used. The JOA scores were assessed at pre- and post-operation (6, 12, 24, 36 months), and effective rate of the operation was calculated. The X-ray examination and MRI examination were performed to evaluate the complications.
RESULTS AND CONCLUSION: There were no complications such as bone cement leakage, heat emission and toxicity occurring during operation. The operating time was 90-180 minutes with the intraoperative blood loss of 600-1 000 mL. The operating time for one vertebral body was 8-12 minutes with the bone cement volume of 3.5-5.0 mL. The average JOA scores were 11 points pre-operation, 23 points at post-operative one year and 25 points at the final follow-up. The effective rate was 66.7% at one year and 77.8% at final follow-up. During follow-ups, 1 case had suffered from adjacent vertebral compressive fracture, there was no pedicle screws loosen, broken or pulled out. The technology of augmenting vertebral body strength using bone cement and pedicle screw fixation is a reliable method for treatment of osteoporosis with degenerative lumbar diseases.