ReviewEuropean spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society2015
Pedicle screw loosening: a clinically relevant complication?
Review in European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 211 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
3D-printed Porous Titanium Alloy Cages Versus PEEK Cages: Pedicle Screw Loosening Rate and Fusion Rate in Patients With Osteoporosis
Pedicle Screw Fixation in Osteoporotic Patients With Degenerative Lumbar Diseases: a Prospective Cohort Study
Who cites it
211 citing papers in PubMed, 1 synthesis or guideline pooled it, 398 citations in OpenAlex.
- Prevalence of osteoporosis in spinal surgery patients older than 50 years: A systematic review and meta-analysis.PloS one · 2023Pooled it
- Use of longer sized screws is a salvage method for broken pedicles in osteoporotic vertebrae.Scientific reports · 2020Trial
- Posterior Lumbar Interbody Fusion with Interspinous Fastener Provides Comparable Clinical Outcome and Fusion Rate to Pedicle Screws.Orthopaedic surgery · 2017Trial
- Clinical and radiological evaluation of cortical bone trajectory screw placement using patient-specific 3D templates: a multicentric prospective study.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2026Article
- Minimally Invasive Lumbopelvic and Transiliac-Transsacral Fixation for a Pathological Sacral Fracture Due to Metastatic Breast Cancer: A Case Report.Journal of orthopaedic case reports · 2026Article
- Clinical and radiographic outcomes of lumbar decompression and fusion with a novel metal-free cortico-pedicular fixation device: A comparative cohort study.North American Spine Society journal · 2026Article
- Multimodal model predicts screw loosening at user-specified postoperative time points after single-level lumbar interbody fusion.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2026Article
- Computed tomography-derived Hounsfield unit mapping for pedicle screw planning in degenerative lumbar disease: a narrative review.Asian spine journal · 2026Article
- MRI-based pedicle bone quality score: a superior predictor over vertebral bone quality score for pedicle screw loosening following transforaminal lumbar interbody fusion.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2026Article
- Risk Factors for Cement Leakage into Segmental Veins during Posterior Spinal Fusion Using Fenestrated Pedicle Screws.Spine surgery and related research · 2026Article
- Prediction of pedicle screw fixation strength under craniocaudal cyclic load: comparison of various models trained on quantitative CT based finite element analysis.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2026Article
- Initial appearance and temporal distribution of pedicle screw loosening after single-level lumbar interbody fusion.Scientific reports · 2026Article
- Predictive performance of CT hounsfield units and MRI vertebral bone quality score following single-level lumbar spinal fusion surgery: which is better.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2026Article
- Single-slice computed tomography-derived pedicle screw trajectory Hounsfield unit values predict screw loosening after lumbar fusion: a retrospective study in Japan.Asian spine journal · 2026Article
- Assessment of influential authors and articles in spine surgery research: a narrative review.Journal of spine surgery (Hong Kong) · 2026Review
- Microscopic far lateral transforaminal lumbar/thoracolumbar interbody fusion for patients with kyphotic Kummell's disease - a retrospective comparison study with bone cement enhanced screws plus vertebroplasty.BMC musculoskeletal disorders · 2026Article
- Exoscopic Extraforaminal Lumbar Interbody Fusion for Lumbar Degenerative Disease: Technical Considerations and Clinical Outcomes During the Early Learning Curve.Journal of clinical medicine · 2026Article
- Pedicle Screw Loosening After Lumbar Spinal Stenosis Surgery and an Analytical Review of Recurrent Loosening: Based on Revision Surgery Experience.Medical science monitor : international medical journal of experimental and clinical research · 2026Article
- Bone density-optimized pedicle screw planning enhances mechanical stability.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2026Article
- Biomechanical comparison of posterior short-segment fixation with or without intermediate screws for thoracolumbar burst fractures under normal and osteoporotic conditions: a finite element analysis.Asian spine journal · 2026Article
151 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeLiterature studies showed a very wide range of pedicle screw loosening rates after thoracolumbar stabilization, ranging from less than 1 to 15 % in non-osteoporotic patients treated with rigid systems and even higher in osteoporotic subjects or patients treated with dynamic systems. Firstly, this paper aims to investigate how much this complication is affecting the success rate of pedicle screw fixation, in both non-osteoporotic and osteoporotic patients, and to discuss the biomechanical reasons which may be related to the variability of the rates found in the literature. The secondary aim was to summarize and discuss the published definitions and conventions about screw loosening from a clinical and radiological point of view.
methodsNarrative literature review.
resultsScrew loosening appears to be a minor problem for fixation and fusion of healthy, non-osteoporotic bone. Pedicle screw fixation in osteoporotic bone is believed to be at risk of loosening, but clinical data are actually scarce. Both expandable and augmented screws may be a viable option to reduce the risk of loosening, but clinical evidence is missing. Posterior motion-preserving implants seems to have a significant risk of screw loosening. Standardization appears to be lacking regarding the radiological assessment. Marked differences in the loosening rates found based either on planar radiography or on CT scanning were observed.
conclusionsReported loosening rates primarily depended on the protocol used for the clinical examination during follow-up and on the conventions used for the radiological assessment. Aiming to a better comparability of published data, we recommend the authors of clinical studies to describe which criteria were used to assess a loosened screw, as well as the protocol of the clinical follow-up examination. Low-dose CT should be used for the assessment of screw loosening whenever possible.
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.