Abstract
Introduction: We assessed our results of posterior transpedicular fixation using PMMA augmented fenestrated screws for osteoporotic vertebral fractures of thoracic or lumbar spine with or without neurological deficits.
Methods: From January 2014 to December 2016, 31 patients with confirmed osteoporotic (T-score <-2.5) vertebral fractures underwent pedicular screw fixation using cement-injectable cannulated pedicle screws. Clinical outcomes were evaluated using a Visual Analog Scale and the Oswestry Disability Index. The patients had radiographic follow-up examinations after 1, 3, 6, and 12 months and once per year thereafter, with the minimum follow-up duration of 2 years.
Results: The Visual Analog Scale (decreased from 8.1 to 3.6) and Oswestry Disability Index (decreased from 76 to 34) scores showed a significant reduction of local pain and disability (p <0.01). Asymptomatic cement leakage occurred in seven patients, without any neurological sequelae; other less serious complications were also observed. Radiological observation indicated a satisfactory improvement of local kyphosis, without significant loosening or pulling out of the screws.
Conclusion: The polymethylmethacrylate augmentation technique using bone cement-injectable cannulated pedicle screws is a feasible and relatively safe method for operative management of osteoporotic vertebral fractures. Crucial factors for successful use of augmented screws include careful patient selection and proper technique implementation.