Minimally Invasive Screw Cement Augmentation in Pedicle Technique (MIS CAPT) for Spine Fixation in Osteoporosis Fragility Fracture and Non-Fracture Patient: Surgical Technique, Indication and 1-year Outcome Evaluation

Abstract

OBJECTIVES: The aim of this study is to describe novo technique of cemented augmentation with percutaneous pedicle screws called “Minimally Invasive Screw Cement Augmentation in Pedicle Technique (MIS CAPT)” which can be used with ordinary percutaneous screws in both fracture and non-fracture osteoporotic fragile bone patients. MATERIALS AND METHODS: Sixty-six cases of HIV negative who were suspected of pulmonary tuberculosis were recruited, sputum examination of acid fast stain and culture, chest x-ray, urine TB LAM were sent, bronchoscopy and washing and biopsy were performed among 12 cases. RESULTS: The patients were divided into the non-fracture group (n = 12) and the fracture group (n = 12). Mean ages of patient were over 70 years old. Mean estimated blood loss and the operative time were lower in the fracture group than those of the non-fracture group (107.5 vs. 758.3 ml and 174.7 vs. 405.5 min., respectively). All patients in the fracture group were discharged from intensive care unit within 24 hours, while 25% of the non-fracture were unable. The mean time to start ambulation in the fracture and the non-fracture group was 17.5 and 48.5 hours, respectively. The hospital stay was approximately 7–9 days in both groups. All patients had no postoperative neurological complications or infections. Minor cement leakage (9.4%) was found in the fracture group without any effect on health or outcome. Within 1-year follow-up, no loosening was found in all MIS CAPT screws and in the fracture group, only 2.8-degree loss of kyphosis reduction was presented in the fracture group. CONCLUSION: It is concluded that MIS CAPT is an effective-versatile minimally invasive spinal fixation technique in osteoporotic or fragility bone conditions. The outcome is excellent in terms of successful operation, minimal complications, and rigid fixation in both fracture and non-fracture elderly fragility bone patients.