Clinical application of bone cement augmentation of pedicle screws in lumbar spinal canal stenosis with osteoporosis

SUN Zhi-guo; WANG Hao; ZHAO Xi-bin; YUAN Hong

doi:10.3969/j.issn.2095-252X.2015.05.011

Abstract：Objective To investigate the clinical application of bone cement augmentation of pedicle screws in lumbar spinal canal stenosis with osteoporosis.Methods From June 2010 to June 2013,13 patients ( 4 males,9 females ) of lumbar spinal canal stenosis with osteoporosis were recruited,with an average age of 68 years old ( range: 61-77 years ).Nine cases were in stage two.Four cases were in stage three.Assessing osteoporosis according to Jikei,there were 4 cases of stage Ⅱ and 9 cases of Ⅲ.Bone cement augmentation of the screw channel was conducted before pedicle screw ifxation.Thirty-six bone cement augmented pedicle screws were implanted.Using X-ray during and after the operation to compare pedicle screw positions and observe the stability.Visual analogue scores ( VAS ) was applied to evaluate low back pain and leg pain 1 day before surgery,7 days and 3 months postoperatively.Results Complications due to the bone cement leakage,heat-induced effects and toxicity in the screw implantation process did not occur.The low back pain and leg pain symptoms were improved signiifcantly 1 week postoperatively.VAS were ( 2.20 ± 1.18 ) points and ( 2.32 ± 0.35 ) points respectively,with statistical signiifcance comparing with preoperative condition (P＜0.05 ).VAS were ( 1.82 ± 0.15 ) points and ( 1.14 ± 0.44 ) points in 3 months postoperatively,with no statistical significance comparing with the condition 1 week postoperatively (P＞0.05 ).Thirteen patients were followed up.The average followed up time was 14 months ( range: 8-16 months ).Thirteen cases obtained bony fusion.X-ray showed no loosening,fracture or falling of the internal fixation.No radiolucent lines appeared around the screws.Conclusions Application of bone cement augmentation of pedicle screws in lumbar spinal canal stenosis with osteoporosis can receive satisfactory short-term clinical outcomes.