[Intraoperative revision of initially loosened pedicle screws].

[Intraoperative revision of initially loosened pedicle screws]. Oper Orthop Traumatol. 2019 Jun 03;: Authors: Weiser L, Sehmisch S, Viezens L, Lehmann W Abstract OBJECTIVE: Intraoperative revision of initially loosened pedicle screws. INDICATIONS: Intraoperatively loosened/stripped pedicle screws. CONTRAINDICATIONS: None. SURGICAL TECHNIQUE: Removal of the loosened/stripped pedicle screw. Checking the screw channel and re-implantation using a different trajectory, a larger screw diameter or a cement-augmented pedicle screw. POSTOPERATIVE MANAGEMENT: Early functional mobilization and initiation of osteoporosis therapy if indicated. RESULTS: A biomechanical study with human vertebral bodies was performed. Augmented and not augmented pedicle screws were tested until loosening using a fatigue testing setup. After loosening occurred a subsequent augmentation of the loosened, not augmented screw was performed, and it was tested using a fatigue test again. Both the initial (p = 0.009) and the augmentation after loosening (p = 0.001) showed a significant increase in failure load compared to the non-augmented pedicle screws. In our own patient collective from April 2016 to August 2018, 11 of 524 patients treated with pedicle screws showed intraoperative screw loosening. This was revised in 6 cases with a subsequent augmentation and in 5 cases with a larger screw diameter. In the pos...
Source: Operative Orthopadie und Traumatologie - Category: Orthopaedics Authors: Tags: Oper Orthop Traumatol Source Type: research