Clinical application of a pedicle nail system with polymethylmethacrylate for osteoporotic vertebral fracture

European Spine Journal

Hitoshi Konishi²  Keiya Yamana²  Yoshihisa Sugimoto³  Toshifumi Ozaki¹  Tomoyuki Takigawa¹  Masato Tanaka³ 

[1]Department of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Science, Okayama, Japan

[2]Department of Orthopaedic Surgery, Okayama Citizens’ Hospital, Okayama, Japan

[3]Department of Orthopaedic Surgery, Okayama University Hospital, Okayama, Japan

关键词: Osteoporosis;    Pedicle screw;    Compression fracture;    PMMA;    Spinal fusion;   

DOI  :  10.1007/s00586-010-1402-1

学科分类：骨科学

来源: Springer

【 摘 要 】

The instrumentation of the osteoporotic spine may sometimes result in failure due to the loosening or pullout of the conventional pedicle screw. Moreover, augmentation of screws with polymethylmethacrylate (PMMA) has risks of complications. We developed a new and original pedicle nail system with PMMA for osteoporotic vertebral fractures. A clinical evaluation of this novel pedicle nail system utilized in patients with an osteoporotic vertebral collapse was performed to determine the effectiveness and safety of this technique. Thirty-four elderly patients who suffered from osteoporotic compression fractures were treated by posterolateral fusion using the pedicle nail system. The mean follow-up period was 37 months. Of the 25 patients with neurological symptoms, two patients improved two stages at the Frankel level. Fifteen patients improved one stage at the Frankel level, and eight other patients improved, however, their improvement did not exceed a Frankel level. Nine cases with neuralgia symptoms improved from 4.4 to 2.2 points on average on the Denis pain scale (p < 0.01). The fusion rate was 94% as determined by X-rays of flexion and extension, and the correction of the compression fracture site was maintained well. A pedicle nail system stabilizes the spinal column with osteoporosis and reduces the instrumentation failure. The technique for the insertion of the pedicle nail reduces complication from cement augmentation. The authors speculate that the strategy using the pedicle nail system for osteoporotic spine may be effective and safe when the surgery is performed through a posterior approach.

【 授权许可】

Unknown