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Tytuł:
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Comparison of Long Segmental Dorsal Stabilization with Complete Versus Restricted Pedicle Screw Cement Augmentation in Unstable Osteoporotic Midthoracic Vertebral Body Fractures: A Biomechanical Study.
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Autorzy:
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Spiegl UJ; Department of Orthopaedic, Trauma and Reconstructive Surgery, University Hospital Leipzig, Leipzig, Germany. Electronic address: .
Weidling M; Center for Research on Musculoskeletal Systems (ZESBO), Faculty of Medicine, University Hospital Leipzig, Leipzig, Germany.
Schleifenbaum S; Center for Research on Musculoskeletal Systems (ZESBO), Faculty of Medicine, University Hospital Leipzig, Leipzig, Germany.
Reinhardt M; Department of Diagnostic and Interventional Radiology, University Hospital Leipzig, Leipzig, Germany.
Heyde CE; Department of Orthopaedic, Trauma and Reconstructive Surgery, University Hospital Leipzig, Leipzig, Germany; Center for Research on Musculoskeletal Systems (ZESBO), Faculty of Medicine, University Hospital Leipzig, Leipzig, Germany.
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Źródło:
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World neurosurgery [World Neurosurg] 2020 Nov; Vol. 143, pp. e541-e549. Date of Electronic Publication: 2020 Aug 08.
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Typ publikacji:
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Comparative Study; Journal Article
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Język:
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English
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Imprint Name(s):
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Original Publication: New York : Elsevier
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MeSH Terms:
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Bone Cements*
Pedicle Screws*
Osteoporotic Fractures/*surgery
Spinal Fractures/*surgery
Thoracic Vertebrae/*surgery
Vertebral Body/*surgery
Aged ; Aged, 80 and over ; Biomechanical Phenomena/physiology ; Cadaver ; Female ; Humans ; Male ; Osteoporotic Fractures/diagnostic imaging ; Spinal Fractures/diagnostic imaging ; Thoracic Vertebrae/diagnostic imaging ; Thoracic Vertebrae/injuries ; Vertebral Body/diagnostic imaging
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Contributed Indexing:
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Keywords: Biomechanical testing; Compressive loading; Long-segmental stabilization; Midthoracic vertebral body fracture; Osteoporotic vertebral fracture; Pedicle screw cement augmentation; Posterior stabilization
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Substance Nomenclature:
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0 (Bone Cements)
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Entry Date(s):
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Date Created: 20200811 Date Completed: 20210513 Latest Revision: 20210513
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Update Code:
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20240105
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DOI:
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10.1016/j.wneu.2020.08.002
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PMID:
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32777399
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Objective: To compare the construct stability of long-segmental dorsal stabilization in unstable midthoracic osteoporotic fracture situation with complete pedicle screw cement augmentation (ComPSCA) versus restricted pedicle screw cement augmentation (ResPSCA) of the most cranial and caudal pedicle screws.
Methods: Twelve fresh frozen human cadaveric specimens (Th 4-Th 10) aged 65 years and older were tested in a biomechanical cadaver study. All specimens received a dual-energy X-ray absorption scan and computed tomography scan before testing. Standardized long segmental stabilization was performed. All specimens were matched into pairs. These pairs were randomized into the groups with ComPSCA and ResPSCA. An unstable Th7 fracture was simulated. The maximum load was tested with 6 mm/min until failure or 20 mm had been reached. After testing, a computed tomography scan was performed.
Results: The mean age of the specimens was 87.8 years (range 74-101 years). The mean t score was -3.6 (range -1.2 to -5.3). The mean maximum force in the ResPSCA group was 1600 N (range 1119-1880 N) and 1941 N (1183-3761 N) in the ComPSCA group. No statistically significant differences between both study groups (P = 1.0) could be seen. No signs of screw loosening were visible.
Conclusions: No statistically significant differences in the maximum loads could be seen. No screw loosening of the non-cemented screws was visible. Thus, the construct stability of long segmental posterior stabilization of an unstable midthoracic fracture using ResPSCA seems to be comparable with ComPSCA under axial compression.
(Copyright © 2020 Elsevier Inc. All rights reserved.)
