Clinical efficacy of bone cement injectable pedicle screw system combined with intervertebral fusion in treatment of lumbar spondylolysis and osteoporosis
10.11855/j.issn.0577-7402.2016.10.12
- Author:
Peng-Yi DAI
1
Author Information
1. Department of Spine Surgery, Luoyang Orthopedic-Traumatological Hospital, Henan Orthopedic Hospital
- Publication Type:Journal Article
- Keywords:
Bone cement injectable pedicle screws;
Lumbar vertebrae;
Osteoporosis;
Spinal fusion;
Spondylolysis
- From:
Medical Journal of Chinese People's Liberation Army
2016;41(10):853-858
- CountryChina
- Language:Chinese
-
Abstract:
Objective To observe the therapeutic effect of bone cement injectable pedicle screw system combined with intervertebral fusion for lumbar spondylolysis and osteoporosis. Methods The clinical data were analyzed retrospectively of 21 patients with lumbar spondylolysis and osteoporosis who received treatment of bone cement injectable pedicle screw system and interv ertebral fusion from Aug. 2013 to Nov. 2015. The 21 patients (9 males and 12 females) aged from 60 to 80 years (mean 64 years old); 6 of them presented degenerative spondylolysis, 15 with isthmic spondylolisthesis; 2 cases had I degree slippage, 13 had II degree slippage, 6 had III degree slippage, and all the cases were unisegmental slippage including 9 cases in L4 and 12 cases in L5. Bone mineral density of lumbar vertebrae (L2-L5) was measured with dual-energy X-ray absorptiometry, and T values conforming to the diagnostic criteria of osteoporosis were less than or equal to -2.5; All patients were operated with whole lamina resection for decompression, bone cement injectable pedicle screws system implantation, propped open reduction and fixation intervertebral fusion. The clinical outcomes were determined by the radiographic evaluation including intervertebral height, height of intervertebral foramen, slip distance, slip rate and slip angle, and Oswestry disability index (ODI) on preoperative, 3 months after operation and the end of the time, and the interbody fusion were followed up. Results Cerebrospinal fluid leakage of incision was observed in two cases after operation, compression and dressing to incision, Trendelenburg position, dehydration and other treatments were taken, and the stitches of incisions were taken out on schedule. Slips in the 21 patients were reset to different extent, and lumbar physiological curvatures were recovered. The intervertebral height and height of intervertebral foramen were obviously higher 3 months after operation than that before operation (P<0.05), and the slip distance, slip rate, slip angle and ODI scores were markedly shorter or smaller 3 months after operation than that before operation (P<0.05). Follow-up was done for 16-26 months (average of 20.5 months). All the judgment indexes mentioned above were statistically different in the last following up than that before operation (P<0.05), but no significant difference compared to that of 3 months after operation (P>0.05). Based on the ODI score, the excellent/fine rate was 90.6% and 92.5% for 3 months after operation and the last follow-up, respectively. During the period of following up, no loss of the correction degrees, no loosening of the screws, and 19 cases were noted bony fusion with the fusion success rate of 90.5%. Conclusion The treatment effect of bone cement injectable pedicle screw system and intervertebral fusion for lumbar spondylolysis and osteoporosis is satisfied.
