Comparison of cement-augmented pedicle screw and conventional pedicle screw for the treatment of osteoporotic spinal disease

Abstract

Abstract Study design: A retrospective cohort study. Objective: To compare the safety and clinical efficacy between using cement-augmented pedicle screws (CAPS) and conventional pedicle screws (CPS) in patients with osteoporosis. Summary of background data: Management of osteoporosis in patients undergoing spine surgery is challenging. The clinical efficacy and potential complications of the mid-term performance of the CAPS technique in osteoporotic spinal diseases remain to be evaluated. Patients and methods: The data of 155 patients with osteoporotic spinal disease who were treated with screw fixation from May 2016 to December 2019 were retrospectively analyzed in this study. The patients were divided into the following two groups according to the type of screw used: (I) the CAPS group (n=99); and (II) the CPS group (n=56). Relevant data were compared between two groups, including the demographics data, clinical results and complications. Results: The difference in the VAS, ODI and JOA scores at three and six months after the operation between the two groups was statistically significant (P<0.05). Four cemented screws loosening were observed in the CAPS group (loosening rate 4/470, 0.85%) and 17 screws loosening were observed in the CAP group (loosening rate 17/272, 6.25%). In the CAPS group, a total of 470 augmented screws were used, and cement leakage was observed in 34 screws (7.23%), but no obvious clinical symptoms or serious complications were observed. At 12 months after surgery and the final follow-up, asignificant difference in the fusion rate was found between the two groups. Adjacent vertebral fractures occurred in seven patients in the CAPS group and two in the CPS group. Conclusions: CAPS technique is an effective strategy for the treatment of osteoporotic spinal diseases with a higher fusion rate and lower screw loosening rate than CPS.