[Techniques to increase pedicle screw stability in osteoporotic vertebrae].

[Techniques to increase pedicle screw stability in osteoporotic vertebrae]. Oper Orthop Traumatol. 2019 Jun 03;: Authors: Weiser L, Sehmisch S, Lehmann W, Viezens L Abstract OBJECTIVE: Operative stabilisation of osteoporotic vertebral fractures. INDICATIONS: Fractures of the thoracic and lumbar spine. CONTRAINDICATIONS: None. SURGICAL TECHNIQUE: Preoperative determination of expected bone mineral density. Implantation of pedicle screws in special trajectories, cement augmentation of the screws and use of alternative implants. POSTOPERATIVE MANAGEMENT: Early functional mobilisation and initiation of osteoporosis therapy if indicated. RESULTS: A biomechanical cadaver study with human vertebral bodies was performed. There was a highly significant correlation between bone mineral density and the fatigue load (r2 = 0.839, p < 0.001). Specimens with bone mineral density below 80 mg/cm3 only reached 60% of the fatigue load compared to the specimens with adequate bone quality (>120 mg/cm3) and therefore stability mightbe insufficient and an additional stabilisation should be considered. In osteoporotic vertebrae, the fatigue strength of cement augmented screws was increased by 52% compared to the non-augmented screws (fatigue load non-augmented: 173 N, augmented: 263 N; p = 0.001). Studies conducted by other research groups have demonstrated the effect of various screw traje...
Source: Operative Orthopadie und Traumatologie - Category: Orthopaedics Authors: Tags: Oper Orthop Traumatol Source Type: research