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  4. Cement augmentation versus extended dorsal instrumentation in the treatment of osteoporotic vertebral fractures: A biomechanical comparison
 
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Cement augmentation versus extended dorsal instrumentation in the treatment of osteoporotic vertebral fractures: A biomechanical comparison

Publikationstyp
Journal Article
Date Issued
2016-08
Sprache
English
Author(s)
Weiser, Lukas  
Dreimann, Marc  
Huber, Gerd  
Sellenschloh, Kay  
Püschel, Klaus  
Morlock, Michael  
Rueger, Johannes M.  
Lehmann, Wolfgang  
TORE-URI
http://hdl.handle.net/11420/2979
Journal
Bone & joint journal  
Volume
98-B
Issue
8
Start Page
1099
End Page
1105
Citation
Bone and Joint Journal 8 (98-B): 1099-1105 (2016-08)
Publisher DOI
10.1302/0301-620X.98B8.37413
Scopus ID
2-s2.0-85012827235
Aims Loosening of pedicle screws is a major complication of posterior spinal stabilisation, especially in the osteoporotic spine. Our aim was to evaluate the effect of cement augmentation compared with extended dorsal instrumentation on the stability of posterior spinal fixation. Materials and Methods A total of 12 osteoporotic human cadaveric spines (T11-L3) were randomised by bone mineral density into two groups and instrumented with pedicle screws: group I (SHORT) separated T12 or L2 and group II (EXTENDED) specimen consisting of T11/12 to L2/3. Screws were augmented with cement unilaterally in each vertebra. Fatigue testing was performed using a cranial-caudal sinusoidal, cyclic (1.0 Hz) load with stepwise increasing peak force. Results Augmentation showed no significant increase in the mean cycles to failure and fatigue force (SHORT p = 0.067; EXTENDED p = 0.239). Extending the instrumentation resulted in a significantly increased number of cycles to failure and a significantly higher fatigue force compared with the SHORT instrumentation (EXTENDED non-augmented + 76%, p < 0.001; EXTENDED augmented + 87%, p < 0.001). Conclusion The stabilising effect of cement augmentation of pedicle screws might not be as beneficial as expected from biomechanical pull-out tests. Lengthening the dorsal instrumentation results in a much higher increase of stability during fatigue testing in the osteoporotic spine compared with cement augmentation.
DDC Class
600: Technology
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