Application value of cortical bone trajectory screws in osteoporotic lumbar posterior fusion surgery

doi:10.3969/j.issn.2095-4344.0310

Abstract

Abstract:

BACKGROUND: Conventional pedicle screw fixation is not appropriate for osteoporotic lumbar posterior fusion surgery, because of screw loosening, displacement, and prolapse, and pedicle fractures caused by screw-broken cortical bone.

OBJECTIVE: To introduce the application of cortical bone trajectory (CBT) screws in the posterior lumbar fusion surgery of osteoporosis and to evaluate its application value.

METHODS: Clinical data of 16 patients with degenerative lumbar spine undergoing CBT screws combined with posterior lumbar fusion surgery were retrospectively analyzed. The operation time, intraoperative blood loss, intraoperative and postoperative complications were recorded. The preoperative, postoperative and last-follow-up Visual Analogue Scale scores were used to assess the pain and the Japanese Orthopaedic Association score was used to assess the lumber function. The bone graft fusion and fusion rate at the last follow-up were observed and calculated, respectively.

RESULTS AND CONCLUSION: (1) The surgery was successful in each patient. No complications such as nerve and blood vessel injuries, and the screw failure caused by insufficient screw holding force or nail path damage occurred. There was none case of screw loosening, shedding, or displacement during follow-up. (2) The operation time was (168.5±37.1) minutes and the intraoperative blood loss was (184.2±25.9) mL. (3) The Visual Analogue Scale and Japanese Orthopaedic Association scores postoperatively and at last follow-up were significantly improved compared with those at baseline (P < 0.05), and the scores showed no significant differences postoperatively and last follow-up (P > 0.05). (4) At the last follow-up, the fusion cages were in place, and fusion was satisfactory with a fusion rate of 100%. (5) In summary, the combination of CBT screws and posterior lumbar fusion surgery in the treatment of osteoporotic lumbar degenerative lesions can obtain a good fixation effect without screw-related complications, so it is a satisfactory placement method.

中国组织工程研究杂志出版内容重点：人工关节；骨植入物；脊柱；骨折；内固定；数字化骨科；组织工程

Key words: Lumbar Vertebrae, Osteoporosis, Spinal Fusion, Tissue Engineering

CLC Number:

R318

Hao Shen-shen, Li Chang-hong, Liu Zhi-bin, Wang Fei . Application value of cortical bone trajectory screws in osteoporotic lumbar posterior fusion surgery[J]. Chinese Journal of Tissue Engineering Research, 2018, 22(23): 3628-3633.

Figures/Tables 1

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