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Potential contribution of pedicle screw design to loosening rate in patients with degenerative diseases of the lumbar spine:An observational study

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World Journal of Orthopedics 2021年第5期12卷 310-319页

作者： Andrey Bokov Svetlana Pavlova Anatoliy Bulkin alexandr aleynik Sergey Mlyavykh Department of Oncology and Neurosurgery Federal State Budgetary Educational Institution of Higher Education“Privolzhsky Research Medical University”of the Ministry of Health of the Russian FederationNizhniy Novgorod 603000Russia

BACKGROUND The majority of published data report the results of biomechanical tests of various design pedicle screw *** clinical relevance and relative contribution of screw design to instrumentation stability have been insufficiently *** To estimate the contribution of screw design to rate of pedicle screw loosening in patients with degenerative diseases of the lumbar *** This study is a prospective evaluation of 175 patients with degenerative diseases and instability of the lumbar spine *** underwent spinal instrumentation employing pedicle screws with posterior only or transforaminal interbody ***-up was for 18 *** with signs of pedicle screw loosening on computed tomography were registered;logistic regression analysis was used to identify the factors that influenced the rate of *** Parameters included in the analysis were screw geometry,type of thread,external and internal screw diameter and helical pitch,bone density in Hounsfield units,number of levels fused,instrumentation without anterior support,laminectomy,and unilateral and bilateral total facet joint *** rate of screw loosening decreased with the increment in outer diameter,decrease in core diameter and helical *** rate of screw loosening correlated positively with the number of fused levels and decreasing bone *** facet joint removal significantly favored pedicle screw *** influence of other factors was *** Screw parameters had a significant impact on the loosening rate along with bone quality characteristics,the number of levels fused and the extensiveness of *** significance of the influence of screw parameters was comparable to those of patient-and surgery-related *** screw loosening was influenced by helical pitch,inner and outer diameter,but screw geometry and thread type were insignificant factors.

关键词： Degenerative diseases Lumbar spine Pedicle screw design Pedicle screw loosening

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