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Augmentation of fenestrated pedicle screws with cement in patients with osteoporotic spine


Mahmoud Abousayed , Ahmed Sultan , Wael Koptan , Yasser El Miligui

Abstract

Study design: Retrospective observational study Purpose: To evaluate the purchase of fenestrated pedicle screws augmented with cement in patients with osteoporosis. Background: Backing out and failure of pedicle screws in patients with osteoporosis is becoming a big problem due to wide use of these screws nowadays. Patients and methods: From May 2015 to January 2016, 25 patients with a poor bone stock condition underwent posterior fixation by fenestrated pedicle screws and cement augmentation. Assessment of pain improvement was done by visual analogue scale (VAS) score while long-term clinical outcome was assessed by Oswestry low back disability questionnaire (Oswestry disability index ODI). Implant stability was evaluated by plain radiography. Complications were evaluated in all cases. Results: All patients were followed up clinically and radiographically for a mean of 24.84 months. There was significant reduction in pain and improvement of quality of life as detected by VAS scores and ODI questionnaire consecutively (P value<0.001). No radiological loosening or backing out of screws was observed. Cement leakage occurred in five cases. Conclusion: Augmentation of fenestrated screws with cement provided effective and lasting purchase in patients with osteoporosis. The only clinical complication strictly related to this technique was cement leakage.



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