ArticleBMC musculoskeletal disorders2021
Comparative analysis of clinical factors associated with pedicle screw pull-out during or immediately after surgery between intraoperative cone-beam computed tomography and postoperative computed tomography.
Article in BMC musculoskeletal disorders, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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Who cites it
7 citing papers in PubMed, 14 citations in OpenAlex.
- Automated multi-objective pedicle screw planning.Journal of spine surgery (Hong Kong) · 2026Article
- Tricortical screw spinal fixation: a scoping review and introduction of technique, biomechanical advantages, and clinical outcomes in high-risk vertebral fractures.Neurosurgical review · 2025Article
- Impact of Fixation Length for Single-Level Spinal Metastasis Surgery in the Elderly: A Multicenter Study.Cureus · 2025Article
- Our C-Arm-Free Minimally Invasive Technique for Spinal Surgery: The Thoracolumbar and Lumbar Spine-Based on Our Experiences.Medicina (Kaunas, Lithuania) · 2023Review
- Systematic Literature Review and Meta-Analysis on the Clinical Outcomes of Spine Surgeries in Patients with Concurrent Osteoporosis.Spine surgery and related research · 2023Review
- Clinical Effect of Transverse Process Hook with K-Means Clustering-Based Stratification of Computed Tomography Hounsfield Unit at Upper Instrumented Vertebra Level in Adult Spinal Deformity Patients.Journal of Korean Neurosurgical Society · 2023Article
- Influence of thread design on anchorage of pedicle screws in cancellous bone: an experimental and analytical analysis.Scientific reports · 2022Article
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Authors and funding
7 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundNo studies to date have elucidated the clinical factors associated with pedicle screw pull-out during or immediately after surgery. The aim of this study was to assess the frequency of pedicle screw pull-out by comparing intraoperative scans obtained using cone-beam computed tomography (CBCT) with postoperative scans obtained using computed tomography (CT). We also sought to determine the incidence of pedicle screw pull-out and identify relevant risk factors.
methodsThis was a retrospective analysis of prospectively collected data for 742 pedicle screws placed in 76 consecutive patients who underwent at least triple-level posterior fixation for thoracic or lumbar spinal injury, spinal metastasis, or pyogenic spondylitis between April 2014 and July 2020. Pedicle screw pull-out distance in the axial and sagittal planes was compared between CT scans obtained 2 days postoperatively and CBCT images acquired intraoperatively. Risk factors associated with pedicle screw pull-out were investigated by multivariate logistic regression analysis.
resultsPedicle screw pull-out was seen with 58 pedicle screws (7.8%) in 26 patients (34.2%). There were significant differences in age, number of fused segments, frequency of diffuse idiopathic skeletal hyperostosis (DISH), and medical history of osteoporosis for pedicle screw pull-out. Risk factors for pedicle screw pull-out were older age (odds ratio 1.07, 95% confidence interval 1.02-1.130) and a diagnosis of DISH (odds ratio 3.35, 95% confidence interval 1.12-10.00). Several cases suggest that use of connecting rods was an important factor in intraoperative pedicle screw pull-out.
conclusionsOur findings suggest that age, number of fused segments, presence of DISH, and medical history of osteoporosis are risk factors for pedicle screw pull-out, with the greatest being older age and DISH.
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