Effectiveness of Sublaminar Mersilene tape Augmented Pedicle Screws Fixation for Osteoporotic Vertebral Compression Fracture: Low-cost Modality

Abstract

Abstract Background: Gradually kyphosis and collapse are a natural history of osteoporotic vertebral compression fractures (OVCF). The principle of OVCF is fixing instability, providing anterior support, and decompression. The osteoporotic spine has weak and rarified trabeculae in the cancellous bone and pedicles, which offers little resistance against screw pull-out. The sublaminar implant relies on the lamina for holds that is the strongest part of vertebrae. The study purpose was to assess the safety and efficacy of sublaminar mersilene tape augmented pedicle screws fixation as a novel and low-cost modality for OVCFs instrumentation fixation. Methods: A retrospective study of 40 consecutive patients of the OVCFs. All patients were operated with open decompression, pedicle screw fixation, and sublaminar mersilene tape augmentation. Preoperative and postoperative clinical (visual analog scale [VAS], modified Oswestry disability index [M-ODI], neurologic deficit, revision surgeries, and infection) and radiological (axial collapse, fracture union, implant failure/back out,) parameters were compared to describe the utility of sublaminar mersilene tape augmented pedicle screws for OVCFs treatment. Results: Compete neurological improvement was noted in 38 patients and two patients had Frankel Garde D neurology. The mean VAS was significantly improved from preoperative 8.98±0.60 to 2.76±0.54, final follow-up and M-ODI from 80.10±6.90 to 15.30±6.90. The mean local kyphosis angle was improved from 23.20°±5.90° preoperative to 5.30°±3.9°postoperatively and 3.30°± 2.50°loss of correction at final follow-up. There was no pseudoarthrosis and implant failure noted. No iatrogenic dural or nerve injury. Conclusion: Sublaminar mersilene tape augmentation relies on the lamina for its hold, which is the strongest part of an osteoporotic vertebra. Sublaminar mersilene tape augmented pedicle screws fixation is a novel and low-cost modality for OVCFs. It provides significant improvement in clinical and radiological outcomes. This technique is an easy learning curve, user-friendly and safe, which makes this a viable alternative option for OVCFs fixation.