Innovation in surgical techniques for screw fixation in patients with osteoporotic spine

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J Clin Med. 2022 May 4;11(9):2577. doi: 10.3390/jcm11092577.

ABSTRACT

Osteoporosis is a common disease in older people and is a major public health problem worldwide. It is not uncommon for spine surgeons to perform instrumented spinal fusion surgeries for osteoporotic patients. However, in patients with severe osteoporosis, instrumented fusion may lead to screw loosening, implant failure, or non-union due to poor bone quality and decreased screw stability. pedicle as well as an increased risk of graft collapse. Additionally, revision surgeries to correct failing instrumentation are becoming more common in patients with osteoporosis. Therefore, techniques to improve pedicle screw fixation are needed in spine surgeries for osteoporotic patients. To date, various instrumentation methods, such as supplemental hook, sublaminar tape, and sacral alar iliac screws, and modified screwing techniques are available to reinforce pedicle screw fixation. Additionally, several materials, including polymethyl methacrylate and hydroxyapatite stick/granules, to be inserted into prepared screw holes, can be used to enhance screw fixation. Numerous biomechanical tests confirm the effectiveness of these augmentation methods. Here we review current therapeutic strategies for screw fixation and augmentation methods in the surgical treatment of patients with osteoporotic spine.

PMID:35566703 | DOI: 10.3390/jcm11092577

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