| Segmental polymethylmethacrylate-augmented pedicle screw fixation in patients with bone softening caused by osteoporosis and metastatic tumor involvement: a clinical evaluation. | |
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MedLine Citation:
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PMID: 17881965 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: Instrumentation of the osteoporotic spine may result in bone failure because of pedicle screw loosening and pullout. A clinical evaluation of a novel fenestrated bone tap used in pedicle screw augmentation was performed to determine the performance and safety of this technique. METHODS: Over a 2.5-year period, the clinical and radiographic results of 119 consecutive patients who underwent instrumented arthrodesis were reviewed. Of these patients, 23 had bone softening secondary to osteoporosis and/or metastatic spinal tumor involvement. These patients underwent surgical decompression and spinal instrumentation. RESULTS: Six patients (26%) had metastatic spine disease (squamous cell lung carcinoma, renal cell carcinoma, bladder carcinoma, breast, prostate, and uterine adenocarcinoma); five patients (22%) had a degenerative spondylolisthesis; and 12 patients (52%) had burst fractures, eight as a result of benign causes and four as a result of metastatic disease. Four (17%) patients underwent revision surgery of previous pedicle screw failure resulting from bone softening and pseudarthrosis. A total of 98 levels were fused using 158 polymethylmethacrylate-augmented screws. None of the patients experienced operative death, myocardial infarction, hypoxemia, intraoperative hypotension, radiculopathy, or myelopathy. Asymptomatic anterior cement extravasation was observed in nine patients (39%). There was one asymptomatic polymethylmethacrylate pulmonary embolus and one wound infection. There was no significant relationship between cement extravasation and the quantity used, levels augmented, or location (P > 0.05). There were no construct failures. CONCLUSION: Polymethylmethacrylate-augmented pedicle screw fixation reduces the likelihood of pedicle screw loosening and pullout in patients with osteoporosis requiring instrumented arthrodesis. |
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Authors:
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Bruce M Frankel; Tanya Jones; Chiang Wang |
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Publication Detail:
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Type: Comparative Study; Evaluation Studies; Journal Article |
Journal Detail:
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Title: Neurosurgery Volume: 61 ISSN: 1524-4040 ISO Abbreviation: Neurosurgery Publication Date: 2007 Sep |
Date Detail:
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Created Date: 2007-09-20 Completed Date: 2007-11-07 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 7802914 Medline TA: Neurosurgery Country: United States |
Other Details:
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Languages: eng Pagination: 531-7; discussion 537-8 Citation Subset: IM |
Affiliation:
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Department of Neurosurgery, Medical University of South Carolina, Charleston, South Carolina 29425, USA. frankel@musc.edu |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adult Aged Aged, 80 and over Bone Density* Bone Screws / standards* Female Follow-Up Studies Humans Internal Fixators / standards Male Middle Aged Osteoporosis / complications, surgery* Polymethyl Methacrylate / standards* Spinal Neoplasms / complications, surgery* |
| Chemical | |
Reg. No./Substance:
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9011-14-7/Polymethyl Methacrylate |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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