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Reduced cement volume does not affect screw stability in augmented pedicle screws
Citation Link: https://doi.org/10.15480/882.2804
Publikationstyp
Journal Article
Date Issued
2020-03-23
Sprache
English
Institut
TORE-DOI
TORE-URI
Journal
Volume
29
Issue
6
Start Page
1297
End Page
1303
Citation
European Spine Journal 6 (29): 1297-1303 (2020-06-01)
Publisher DOI
Scopus ID
Publisher
Springer
Purpose: Cement augmentation of pedicle screws is able to improve screw anchorage in osteoporotic vertebrae but is associated with a high complication rate. The goal of this study was to evaluate the impact of different cement volumes on pedicle screw fatigue strength. Methods: Twenty-five human vertebral bodies (T12–L4) were collected from donors between 73 and 97 years of age. Bone density (BMD) was determined by quantitative computed tomography. Vertebral bodies were instrumented by conventional pedicle screws, and unilateral cement augmentation was performed. Thirteen vertebrae were augmented with a volume of 1 ml and twelve with a volume of 3 ml bone cement. A fatigue test was performed using a cranial–caudal sinusoidal, cyclic load (0.5 Hz) with increasing compression force (100 N + 0.1 N/cycles). Results: The load to failure was 183.8 N for the non-augmented screws and was increased significantly to 268.1 N (p < 0.001) by cement augmentation. Augmentation with 1 ml bone cement increased the fatigue load by 41% while augmentation with 3 ml increased the failure load by 51% compared to the non-augmented screws, but there was no significant difference in fatigue loads between the specimens with screws augmented with 1 ml and screws augmented with 3 ml of bone cement (p = 0.504). Conclusion: Cement augmentation significantly increases pedicle screw stability. The benefit of augmentation on screw anchorage was not significantly affected by reducing the applied volume of cement from 3 ml to 1 ml. Considering the high risk of cement leakage during augmentation, we recommend the usage of a reduced volume of 1 ml bone cement for each pedicle screw. Graphic Abstract: These slides can be retrieved under Electronic Supplementary Material [Figure not available: see fulltext.].
Subjects
Bone mineral density
CAPSI
Cement augmentation
Cement volume
Pedicle screw
DDC Class
570: Biowissenschaften, Biologie
600: Technik
610: Medizin
More Funding Information
Open Access funding provided by Projekt DEAL.
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