The Risk of Intravenous Cement Leakage and Short-term Outcomes of Selective Cement-augmented Pedicle Screws: A Multicenter Retrospective Study.

IF 1.6 4区医学 Q3 CLINICAL NEUROLOGY Clinical Spine Surgery Pub Date : 2024-12-30 DOI:10.1097/BSD.0000000000001757

Shinji Takahashi, Daisuke Sakai, Shota Ogasawara, Ryo Sasaki, Masato Uematsu, Takahiko Hyakumachi, Akihiko Hiyama, Hiroyuki Katoh, Hidetomi Terai, Akinobu Suzuki, Koji Tamai, Hiroaki Nakamura, Mitsuru Yagi

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Abstract

Study design: Multicenter retrospective cohort study.

Objective: To evaluate the efficacy and safety of using cement-augmented pedicle screw (CAPS) fixation only for the cephalad and caudal vertebral bodies.

Summary of background data: Pedicle screw fixation is less effective in patients with low-quality bone. Although CAPS fixation has shown promise in improving stability and reducing screw loosening in such cases, cement leakage can have serious consequences.

Methods: This study included 65 patients who underwent spinal surgery using CAPS and were followed up for >3 months. Four CAPSs were used in each patient, and 254 CAPSs were included in the analysis.

Results: Of the 65 patients, 36.9% showed intravenous cement leakage, and a low bone mineral density (BMD) was associated with a higher risk of cement leakage. The use of a CAPS on the right side was also potentially associated with a higher risk of leakage. However, the shape and location of the leaked cement remained stable over time. Screw loosening occurred in 3.5% of the CAPSs and was associated with a lower cement volume.

Conclusion: Cement leakage was related to lower BMD. Using CAPS exclusively at the lower or upper instrumentation levels might minimize the risk of cement leakage in osteoporotic patients.

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选择性骨水泥增强椎弓根螺钉静脉内骨水泥渗漏的风险和短期疗效：一项多中心回顾性研究。

研究设计：多中心回顾性队列研究。目的：评价水泥增强椎弓根螺钉（CAPS）固定头、尾椎体的有效性和安全性。背景资料总结：椎弓根螺钉固定对骨质量差的患者效果较差。尽管在这种情况下，CAPS固定在提高稳定性和减少螺钉松动方面表现出了希望，但水泥泄漏可能会造成严重后果。方法：本研究纳入65例采用CAPS进行脊柱外科手术的患者，并对其进行了为期30个月的随访。每例患者使用4个caps，共纳入254个caps。结果：65例患者中，36.9%出现静脉内水泥渗漏，低骨密度（BMD）与水泥渗漏的风险较高相关。在右侧使用cap也可能与更高的泄漏风险相关。然而，随着时间的推移，泄漏水泥的形状和位置保持稳定。螺钉松动发生在3.5%的caps中，并且与较低的水泥体积有关。结论：骨水泥渗漏与骨密度降低有关。在骨质疏松症患者中，仅在较低或较高的内固定水平使用CAPS可以最大限度地减少骨水泥渗漏的风险。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical Spine Surgery Medicine-Surgery

CiteScore

3.00

自引率

5.30%

发文量

236

期刊介绍： Clinical Spine Surgery is the ideal journal for the busy practicing spine surgeon or trainee, as it is the only journal necessary to keep up to date with new clinical research and surgical techniques. Readers get to watch leaders in the field debate controversial topics in a new controversies section, and gain access to evidence-based reviews of important pathologies in the systematic reviews section. The journal features a surgical technique complete with a video, and a tips and tricks section that allows surgeons to review the important steps prior to a complex procedure. Clinical Spine Surgery provides readers with primary research studies, specifically level 1, 2 and 3 studies, ensuring that articles that may actually change a surgeon’s practice will be read and published. Each issue includes a brief article that will help a surgeon better understand the business of healthcare, as well as an article that will help a surgeon understand how to interpret increasingly complex research methodology. Clinical Spine Surgery is your single source for up-to-date, evidence-based recommendations for spine care.