ArticleEuropean spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society2021
Can cavity-based pedicle screw augmentation decrease screw loosening? A biomechanical in vitro study.
Article 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, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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Who cites it
4 citing papers in PubMed.
- Cementation strategies in the osteoporotic, metastatic, or ankylosing thoracolumbar spine in older adults: Cement-associated complications and implant failure.Brain & spine · 2025Article
- Comparison of four in vitro test methods to assess nucleus pulposus replacement device expulsion risk.JOR spine · 2024Article
- The incidence and risk factors for extensive epidural cement leakage in cement-augmented pedicle screw fixation: a multicenter retrospective study.Archives of orthopaedic and trauma surgery · 2024Article
- Anatomic distribution of basivertebral foramen with a magistral form in vertebral bodies of T10~L5 and its clinical significance for extensive epidural cement leakage in cement-augmented pedicle screw fixation: a multicenter case-control study.Journal of orthopaedic surgery and research · 2024Article
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Authors and funding
5 authors.
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Abstract
purposeIn an osteoporotic vertebral body, cement-augmented pedicle screw fixation could possibly be optimized by the creation of an initial cavity. The aim of this study is to compare three test groups with regard to their loosening characteristics under cyclic loading.
methodsEighteen human, osteoporotic spine segments were divided in three groups. Flexibility tests and cyclic loading tests were performed with an internal fixator. The screws were fixed after creation a cavity and with cement (cavity-augmented group), without cavity and with cement (augmented group), and without cavity and without cement (control group). Cyclic loading up to 100,000 cycles was applied with a complex loading protocol. Screw loosening was measured with flexibility tests after implantation and after cyclic loading. Cement distribution was visualized from CT scans.
resultsIn all groups, range of motion increased during cyclic loading, representing significant screw loosening after 100,000 cycles. In both augmented groups, screw loosening was less pronounced than in the control group. The cavity-augmented group showed only a slight tendency of screw loosening, but with smaller variations compared to both other groups. This may be explained with a trend for a more equal and homogeneous cement volume around each tip for the cavity-augmented group.
conclusionThis study demonstrated that creating a cavity may allow a more equal fixation of all pedicle screws with slight reduction of loosening. However, augmentation only through a cannulated screw is almost equivalent, if care is taken that enough cement volume can be pushed out around the tip of the screw.
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