Observational studyBMC musculoskeletal disorders2024
Risk factors of instrumentation failure after laminectomy and posterior cervical fusions (PCF).
Observational study in BMC musculoskeletal disorders, 2024. 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.
- Dental Composite Offers Comparable or Greater Pullout and Shear Strength to Lateral Mass Screw Fixation in a Human Cadaveric Model.International journal of spine surgery · 2026Article
- C-VBQ and CT hounsfield units for DXA-defined low bone mass screening and their associations with bone turnover markers.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
- Endoscopic-assisted anterior transarticular screw fixation and arthrodesis for atlantoaxial instability via a retropharyngeal approach: technical note and preliminary clinical outcomes.North American Spine Society journal · 2026Article
- Effects of proprioceptive neuromuscular facilitation and core stabilization on physical and functional parameters in adolescents with idiopathic scoliosis: a randomized controlled trial.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
- Predictive Value of MRI-Based Vertebral Bone and Endplate Bone Quality Assessments for Screw Loosening and Cage Subsidence in Degenerative Thoracolumbar Spine Surgery: A Systematic Review and Meta-Analysis.International journal of spine surgery · 2025Article
- Article
- Artificial Intelligence in Spinal Imaging and Patient Care: A Review of Recent Advances.Neurospine · 2024Article
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9 authors.
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Abstract
backgroundFor patients with multilevel degenerative cervical myelopathy, laminectomy and posterior cervical fusions (PCF) with instrumentation are widely accepted techniques for symptom relief. However, hardware failure is not rare and results in neck pain or even permanent neurological lesions. There are no in-depth studies of hardware-related complications following laminectomy and PCF with instrumentation.
methodsThe present study was a retrospective, single centre, observational study. Patients who underwent laminectomy and PCF with instrumentation in a single institution between January 2019 and January 2021 were included. Patients were divided into hardware failure and no hardware failure group according to whether there was a hardware failure. Data, including sex, age, screw density, end vertebra (C7 or T1), cervical sagittal alignment parameters (C2-C7 cervical lordosis, C2-C7 sagittal vertical axis, T1 slope, Cervical lordosis correction), regional Hounsfield units (HU) of the screw trajectory and osteoporosis status, were collected and compared between the two groups.
resultsWe analysed the clinical data of 56 patients in total. The mean overall follow-up duration was 20.6 months (range, 12-30 months). Patients were divided into the hardware failure group (n = 14) and no hardware failure group (n = 42). There were no significant differences in the general information (age, sex, follow-up period) of patients between the two groups. The differences in fusion rate, fixation levels, and screw density between the two groups were not statistically significant (p > 0.05). The failure rate of fixation ending at T1 was lower than that at C7 (9% vs. 36.3%) (p = 0.019). The regional HU values of the pedicle screw (PS) and lateral mass screw (LMS) in the failure group were lower than those in the no failure group (PS: 267 ± 45 vs. 368 ± 43, p = 0.001; LMS: 308 ± 53 vs. 412 ± 41, p = 0.001). The sagittal alignment parameters did not show significant differences between the two groups before surgery or at the final follow-up (p > 0.05). The hardware failure rate in patients without osteoporosis was lower than that in patients with osteoporosis (14.3% vs. 57.1%) (p = 0.001).
conclusionsOsteoporosis, fixation ending at C7, and low regional HU value of the screw trajectory were the independent risk factors of hardware failure after laminectomy and PCF. Future studies should illuminate if preventive measures targeting these factors can help reduce hardware failure and identified more risk factors, and perform long-term follow-up.
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