Effect of expandable pedicle screw fixation on the fixation strength of osteoporotic thoracic and lumbar vertebrae

doi:10.3969/j.issn.2095-4344.2017.10.001

Abstract

Abstract:

BACKGROUND: Studies have shown that osteoporosis often leads to a failure in pedicle screw fixation. Considering that the use of ordinary pedicle screw fixation cannot achieve a strong and stable fixation of the osteoporotic vertebra, special measures to strengthen the internal fixation is indispensable.
OBJECTIVE: To evaluate the effect of bone cement augmentation combined with expandable pedicle screw fixation on the fixation strength of osteoporotic thoracolumbar vertebrae.
METHODS: Twenty osteoporotic thoracolumbar vertebral specimens were randomly divided into four groups: conventional pedicle screw group implanted with normal pedicle screw, and the other three groups implanted with expandable pedicle screw. Bone cement augmentation with polymethylmethacrylate (PMMA) and calcium sulfate was done in the PMMA group and calcium sulfate group, respectively, followed by expandable pedicle screw implantation. No bone cement was used in the expandable pedicle screw group. The maximum axial pull-out strength and yield energy absorption value of the unilateral pedicle were detected, and the maximum removal torque of the contralateral pedicle was determined. Bone cement leakage after augmentation was observed.
RESULTS AND CONCLUSION: Compared with the conventional pedicle screw group, the other three groups showed a significant increase in the maximum pull-out strength, maximum removal torque and yield energy absorption values (P < 0.05). Moreover, these parameters were significantly higher in the PMMA and calcium sulfate groups than the expandable pedicle screw group and conventional pedicle screw group (P < 0.05), but there was no significant difference between the PMMA and calcium sulfate groups (P > 0.05). No leakage of bone cement was found in all the groups. To conclude, the combined use of expandable pedicle screw and can significantly enhance the stability of the osteoporotic thoracolumbar vertebrae, and the PMMA and calcium sulfate cements have similar effects.

中国组织工程研究杂志出版内容重点：生物材料；骨生物材料; 口腔生物材料; 纳米材料; 缓释材料; 材料相容性；组织工程

Key words: Osteoporosis, Thoracic Vertebrae, Lumbar Vertebrae, Methylmethacrylates, Calcium Sulfate, Tissue Engineering

CLC Number:

R318

Zhou Qing-zhong, Feng Xiao-lan, Zhang Ge, Jia Xu-feng, Lei Fei, Ye Fei, Feng Da-xiong. Effect of expandable pedicle screw fixation on the fixation strength of osteoporotic thoracic and lumbar vertebrae[J]. Chinese Journal of Tissue Engineering Research, 2017, 21(10): 1477-1482.

Figures/Tables 6

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