Abstract
Study design
A retrospective cohort study.
Objective
To compare the safety and clinical efficacy between using cement-augmented pedicle screws (CAPS) and conventional pedicle screws (CPS) for the treatment of lumbar degenerative patients with osteoporosis.
Summary of background data
Management of lumbar degenerative patients with osteoporosis undergoing spine surgery is challenging. The clinical efficacy and potential complications of the mid-term performance of the CAPS technique in the treatment of lumbar degenerative patients with osteoporosis remain to be evaluated.
Patients and methods
The data of 131 lumbar degenerative patients with osteoporosis who were treated with screw fixation from May 2016 to December 2019 were retrospectively analyzed in this study. The patients were divided into the following two groups according to the type of screw used: (I) the CAPS group (n = 85); and (II) the CPS group (n = 46). Relevant data were compared between two groups, including the demographics data, clinical results and complications.
Results
The difference in the VAS, ODI and JOA scores at three and 6 months after the operation between the two groups was statistically significant (P < 0.05). At 12 months after surgery and the final follow-up, a significant difference in the fusion rate was found between the two groups (P < 0.05). Four cemented screws loosening were observed in the CAPS group (loosening rate 4/384, 1.04%) and 15 screws loosening were observed in the CPS group (loosening rate 15/214, 7.01%). In the CAPS group, a total of 384 augmented screws were used, and cement leakage was observed in 25 screws (25/384, 6.51%), but no obvious clinical symptoms or serious complications were observed. Adjacent vertebral fractures occurred in six patients in the CAPS group and one in the CPS group.
Conclusions
CAPS technique is an effective strategy for the treatment of lumbar degenerative patients with osteoporosis, with a higher fusion rate and lower screw loosening rate than CPS.
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Availability of data and materials
The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request. Declarations.
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Funding
This work was supported by the Shanghai Songjiang District Science and Technology Key Project (No.18sjkjgg48).
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The study was approved by the Institutional Review Board of Shanghai General Hospital (No. 2021094).
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The study was conducted in accordance with the Declaration of Helsinki (as revised in 2013).
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Wang, Y., Zhou, C., Yin, H. et al. Comparison of cement-augmented pedicle screw and conventional pedicle screw for the treatment of lumbar degenerative patients with osteoporosis. Eur J Orthop Surg Traumatol 34, 1609–1617 (2024). https://doi.org/10.1007/s00590-024-03849-2
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DOI: https://doi.org/10.1007/s00590-024-03849-2