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- Title
Radiofrequency-activated PMMA-augmentation through cannulated pedicle screws: A cadaver study to determine the biomechanical benefits in the osteoporotic spine.
- Authors
Karius, T.; Deborre, C.; Wirtz, D. C.; Burger, C.; Prescher, A.; Fölsch, A.; Kabir, K.; Pflugmacher, R.; Goost, H.
- Abstract
<bold>Introduction: </bold>PMMA-augmentation of pedicle screws strengthens the bone-screw-interface reducing cut-out risk. Injection of fluid cement bears a higher risk of extravasation, with difficulty of application because of inconsistent viscosity and limited injection time.<bold>Objective: </bold>To test a new method of cement augmentation of pedicle screws using radiofrequency-activated PMMA, which is suspected to be easier to apply and have less extravasations.<bold>Methods: </bold>Twenty-seven fresh-frozen human cadaver lumbar spines were divided into 18 osteoporotic (BMD ≤ 0.8 g/cm2) and 9 non-osteoporotic (BMD > 0.8 g/cm2) vertebral bodies. Bipedicular cannulated pedicle screws were implanted into the vertebral bodies; right screws were augmented with ultra-high viscosity PMMA, whereas un-cemented left pedicle screws served as negative controls. Cement distribution was controlled with fluoroscopy and CT scans. Axial pullout forces of the screws were measured with a material testing machine, and results were analyzed statistically.<bold>Results: </bold>Fluoroscopy and CT scans showed that in all cases an adequately big cement depot with homogenous form and no signs of extravasation was injected. Pullout forces showed significant differences (p < 0.001) between the augmented and non-augmented pedicle screws for bone densities below 0.8 g/cm2 (661.9 N ± 439) and over 0.8 g/cm2 (744.9 N ± 415).<bold>Conclusions: </bold>Pullout-forces were significantly increased in osteoporotic as well as in non-osteoporotic vertebral bodies without a significant difference between these groups using this standardized, simple procedure with increased control and less complications like extravasation.
- Subjects
BONE screws; OSTEOPOROSIS treatment; POLYMETHYLMETHACRYLATE; BIOMECHANICS; SPINE diseases; THERAPEUTICS; LUMBAR vertebrae surgery; DEAD; LUMBAR vertebrae; MATERIALS testing; OSTEOPOROSIS; COMPLICATIONS of prosthesis; RADIO waves
- Publication
Technology & Health Care, 2017, Vol 25, Issue 2, p327
- ISSN
0928-7329
- Publication type
journal article
- DOI
10.3233/THC-161273