ArticleGlobal spine journal2020
Screw Loosening in Posterior Spine Fusion: Prevalence and Risk Factors.
Article in Global spine journal, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 64 papers, 1 of them a synthesis that pooled it.
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Who cites it
64 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Comparative analysis of the safety and efficacy of fenestrated pedicle screw with cement and conventional pedicle screw with cement in the treatment of osteoporotic vertebral fractures: A meta-analysis.Chinese journal of traumatology = Zhonghua chuang shang za zhi · 2025Pooled it
- Comparative risk of instrumentation failure in dynamic and rigid spinal stabilization: a propensity-matched cohort study.Neurosurgical review · 2026Article
- Orthopedic Biomaterials in the Clinical Reconstruction of Osteoporotic Atlantoaxial Injuries: A Review.Bioengineering (Basel, Switzerland) · 2026Review
- 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
- Review
- Asymmetric cement distribution in the coronal plane increases the risk of prosthetic loosening following total knee arthroplasty: an in-silico study.BMC surgery · 2026Article
- A novel pedicle-PMMA-augmented screw resists reverse windshield-wiper failure in osteoporotic spine fixation: parameter optimization by finite element analysis.BMC musculoskeletal disorders · 2026Article
- A comprehensive review of biomechanical factors influencing pedicle screw fixation strength and the critical role of artificial intelligence.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
- 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
- Radiological evaluation and complications of percutaneous vertebroplasty and fenestrated pedicle screw fixation with bone cement augmentation: propensity-score matched cohort study.BMC musculoskeletal disorders · 2026Article
- PMMA-augmentation of the spinous process as an enhancing-protective measure against bone failure in "through the spinous process-vertebropexy".North American Spine Society journal · 2026Article
- Biomechanical Effect of a Lumbar Interfacet Cage (FFX) Device When Combined With Pedicle Screw Constructs: A Finite Element Study.International journal of spine surgery · 2026Article
- Changes in PFNA nail position do not influence bone healing and femoral head varus in patients with stable intertrochanteric fractures: a comprehensive clinical and biomechanical study.European journal of medical research · 2026Article
- Article
- Analysis of biomechanical load cases for the investigation of pedicle screws ASTM F1717 vs. Toggling.Frontiers in bioengineering and biotechnology · 2026Article
- Biomechanical advantages of double-trajectory screws technique combined with multiple-rod constructs in lumbar pedicle subtraction osteotomy: a finite element analysis study.Frontiers in bioengineering and biotechnology · 2026Article
- Single-Side Iatrogenic Pedicle Injury May Trigger an Increased Risk of Contralateral Screw Loosening: An In Silico Study.JOR spine · 2025Article
- Risk factors for screw loosening following lumbar interbody fusion surgery in degenerative lumbar disease: a systematic review and meta-analysis.Asian spine journal · 2025Article
- Cement Leakage in Cement-Augmented Fenestrated Pedicle Screws for Osteoporotic Spine: Risk Stratification with Quantitative Computed Tomography Analysis.Journal of clinical medicine · 2025Article
4 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
STUDY
designRetrospective cohort study.
objectiveScrew loosening in spinal fusion is poorly defined. Accordingly, its prevalence rates range from 1% to 60%, and its risk factors remain undefined. The goal of this study was to assess the prevalence of screw loosening, according to precise definitions, and to identify factors associated with it.
methodsWe retrospectively reviewed records for 166 patients who underwent a posterior spinal fusion in our institution between 2011 and 2016. We recorded demographic data, osteoporosis, pelvic balance, surgery-related information, and postoperative radiographic data at a minimum follow-up of 6 months. Univariable and multivariable logistic regression models were used. Significance was defined by
resultsWhen loosening was defined by partial pull-out, its prevalence was 9.6% (95% CI 5.6-15); thoracic localization, the use of CrCo (chromium-cobalt) rods, osteoporosis, PI/LL (pelvic incidence/lumbar lordosis) mismatch (preoperative), and frontal imbalance (preoperative) were significant risk factors. When loosening was defined by osteolysis (radiolucent rim) >1 mm around at least 1 screw, its prevalence was 40.4% (95% CI 33-48) and age, scoliosis as indication for fusion, ASA (American Society of Anesthesiologists) 2 or 3, the use of CrCo rods, more than 5 levels fused, no circumferential arthrodesis, postoperative bracing, and sacrum or ilium as the inferior level of instrumentation were also significant risk factors.
conclusionsA clear definition of screw loosening seems essential for a useful analysis of the literature. Osteoporosis, sagittal imbalance, and rigid material appear to be risk factors, regardless of the definition.
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