Radiologic and clinical outcome of the cement augmented pedicle screws after a minimum 2-year follow-up


pedicle screws ; osteoporotic patients ; elderly ; cement augmentation ; mechanical failure ; osteoporosis ; screw loosening ; interbody fusion ; elderly osteoporotic patients ; screw pull-out

Published online: Jul 15 2019

Sinan Karaca , Meriç Enercan , Onur Levent Ulusoy , Azmi Hamaoglu

From the Fatih Sultan Mehmet Training and Research Hospital, Atasehir, Istanbul


T55 patients with cement-augmented pedicle screw were retrospectively analyzed. All patients underwent computed tomography at a minimum of 2 years after index operation. Computed tomography scans were analyzed to determine pedicle screw loosening, cement leakage, and fusion rates at augmented levels. The purpose of this study was to analyze the efficacy and complications of cement augmentation in elderly patients. Screw loosening occurred at fused levels in all patients, except one patient with pseudoarthrosis. All cases of screw loosening occurred at levels without interbody fusion. Extravasation of cement was performed in 7 (12.7%) patients and three (5.4%) patients had asymptomatic pulmonary cement emboli. Three (5.4%) patients had deep wound infection, and they were treated successfully with debridement and antibiotic therapy without need for instrument removal. Cement augmentation of PSs in elderly osteoporotic patients prevents screw pull-out. However, a very low rate of screw loosening may be seen at the levels without interbody fusion.