• World Neurosurg · Nov 2020

    Comparative Study

    Comparison of long segmental dorsal stabilization with complete versus restricted pedicle screw cement-augmentation in unstable osteoporotic midthoracic vertebral body fractures A biomechanical Study.

    • Ulrich J Spiegl, Martin Weidling, Stefan Schleifenbaum, Martin Reinhardt, and Christoph-E Heyde.
    • Department of Orthopaedic, Trauma and Reconstructive Surgery, University Hospital Leipzig, Leipzig, Germany. Electronic address: uli.spiegl@gmx.de.
    • World Neurosurg. 2020 Nov 1; 143: e541-e549.

    ObjectiveTo compare the construct stability of long-segmental dorsal stabilization in unstable midthoracic osteoporotic fracture situation with complete pedicle screw cement augmentation (ComPSCA) versus restricted pedicle screw cement augmentation (ResPSCA) of the most cranial and caudal pedicle screws.MethodsTwelve fresh frozen human cadaveric specimens (Th 4-Th 10) aged 65 years and older were tested in a biomechanical cadaver study. All specimens received a dual-energy X-ray absorption scan and computed tomography scan before testing. Standardized long segmental stabilization was performed. All specimens were matched into pairs. These pairs were randomized into the groups with ComPSCA and ResPSCA. An unstable Th7 fracture was simulated. The maximum load was tested with 6 mm/min until failure or 20 mm had been reached. After testing, a computed tomography scan was performed.ResultsThe mean age of the specimens was 87.8 years (range 74-101 years). The mean t score was -3.6 (range -1.2 to -5.3). The mean maximum force in the ResPSCA group was 1600 N (range 1119-1880 N) and 1941 N (1183-3761 N) in the ComPSCA group. No statistically significant differences between both study groups (P = 1.0) could be seen. No signs of screw loosening were visible.ConclusionsNo statistically significant differences in the maximum loads could be seen. No screw loosening of the non-cemented screws was visible. Thus, the construct stability of long segmental posterior stabilization of an unstable midthoracic fracture using ResPSCA seems to be comparable with ComPSCA under axial compression.Copyright © 2020 Elsevier Inc. All rights reserved.

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