KMID : 1001920110490010075
|
|
Journal of Korean Neurosurgical Society 2011 Volume.49 No. 1 p.75 ~ p.78
|
|
A Case of Pedicle Screw Loosening Treated by Modified Transpedicular Screw Augmentation with Polymethylmethacrylate
|
|
Kang Suk-Hyung
Kim Kyoung-Tae Park Seung-Won Kim Young-Baeg
|
|
Abstract
|
|
|
We report a case of pedicle screw loosening treated by modified transpedicular screw augmentation technique using polymethylmethacrylate (PMMA), which used the anchoring effect of hardened PMMA. A 56-year-old man who had an L3/4/5 fusion operation 3 years ago complained of continuous low back pain after this operation. The computerized tomography showed a radiolucent halo around the pedicle screw at L5. We augmented the L5 pedicle screw with modified pedicle screw augmentation technique using PMMA and performed an L3/4/5 pedicle screw fixation without hook or operation field extension. This modified technique is a kind of transpedicular stiffness augmentation using PMMA for the dead space around the loosed screw. After filling the dead space with 1-2 cc of PMMA, we inserted a small screw. Once the PMMA hardened, we removed the small screw and inserted a thicker screw along the existing screw threading to improve the pedicle screws¡¯ pullout strength. At 10 months¡¯ follow-up, x-ray showed strong fusion of L3/4/5. The visual analogue scale (VAS) of his back pain was improved from 9 to 5. This modified transpedicular screw augmentation with PMMA using anchoring effect is a simple and effective surgical technique for pedicle screw loosening. However, clinical analyses of long-term follow-up and biomechanical studies are needed.
|
|
KEYWORD
|
|
Instrument failure, Osteoporosis, Pedicle screw loosening, PMMA, Pseudoarthrosis, Surgical technique
|
|
FullTexts / Linksout information
|
|
|
|
Listed journal information
|
|
|