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Corresponding Author

Ahmed Mohammed Balaha, MD.

Subject Area

Degenerative, Lumbosacral spine, Surgical techniques, Trauma, Augmentation, Augmentation

Document Type

Original Study

Abstract

Background Data: Spinal instrumentation in patients with osteoporosis is considered challenging. Using screw augmentation with bone cement is one of the methods used to overcome the structural weakness of vertebral bodies to minimize the risk of screws loosening and pullout.

Purpose: This study aims to evaluate the clinical results of using bone cement-augmented solid nonfenestrated screws in osteoporotic patients presented with either fractures or degenerative spinal diseases.

Study Design: This is a retrospective clinical case study.

Patients and Methods: We retrospectively reviewed all patients who had been operated on during the last five years for posterior spinal fixation and proven preoperatively to have osteoporotic spine. All patients had been operated on for spinal fixation using solid nonfenestrated transpedicular screws, which were augmented with bone cement. All patients had been evaluated clinically and radiologically before and after the surgery.

Results: We reported 37 patients (25 females and 12 males) with a main age of 59.19±5.42 years. In total, 20 patients had degenerative spinal diseases and 17 patients had traumatic compression fractures. All participants had osteoporotic spine with a mean T score of -2.8±0.24. Then, 220 screws were inserted into 110 vertebrae. The mean preoperative VAS of back pain was 9.06±0.9 and after 6 months, it dropped to 2.24±0.8. There were three cases (8.1%) of asymptomatic intravenous cement leaks and two cases (5.4%) of asymptomatic intraspinal leaks. There were no reported technique-related mortalities, screw loosening, or screw pullout during 15.24±8.07 months of follow-up.

Conclusion: Solid nonfenestrated augmented pedicle screws are considered a safe and effective method for spinal fixation in patients with either degenerative or traumatic osteoporotic spinal pathologies.

Keywords

Osteoporotic spine, Bone cement, Trauma, Degenerative spine, Solid screws, Fenestrated screws

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