Correlation of bone density to screw loosening in dynamic stabilization: an analysis of 176 patients.
Correlation of bone density to screw loosening in dynamic stabilization: an analysis of 176 patients.
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DOI：
10.1038/s41598-021-95232-y
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发表时间：
2021-09-01
影响因子：
4.6
通讯作者：
Hsu SM
中科院分区：
文献类型：
--
作者：
Chang HK;Ku J;Ku J;Kuo YH;Chang CC;Wu CL;Lirng JF;Wu JC;Huang WC;Cheng H;Hsu SM
尽管骨质疏松症对腰椎融合有负面影响，但其对动态稳定螺钉松动的影响仍然难以捉摸。我们的目的是将骨矿物质密度 (BMD) 与 Dynesys 动态稳定 (DDS) 中的螺钉松动相关联。对因脊椎病、复发性椎间盘突出或 L3-5 低度脊椎滑脱而连续接受 2 级或 3 级 DDS 的患者进行回顾性分析。亨斯菲尔德单位 (HU) 在术前计算机断层扫描 (CT) 上评估有或没有皮质骨 (CB) 的椎体 (VB) 和椎弓根 (CB) 的 BMD。通过射线照片评估螺钉松动并通过 CT 确认。比较松动螺钉和完好螺钉之间的 HU 值。对 176 名患者和 918 个螺钉进行了分析，其中 36 名患者发现了 78 个松动的螺钉（平均随访时间：43.4 个月）。松动的螺钉和完整的螺钉中 VB 的 HU 值相似 (p = 0.14)。松动螺钉的椎弓根 HU 值不显着低于完整螺钉（包括 CB：286.70 ± 118.97 vs. 297.31 ± 110.99，p = 0.45；排除 CB：238.48 ± 114.90 vs. 240.51 ± 108.91，p = 0.88）。所有患者的临床症状均有所改善。总之，HU 值作为 BMD 的替代值，与 DDS 中的螺钉松动无关。因此，骨密度受损的患者可能是动态稳定而不是融合的潜在候选者。
Although osteoporosis has negative impacts on lumbar fusion, its effects on screw loosening in dynamic stabilization remain elusive. We aimed to correlate bone mineral density (BMD) with screw loosening in Dynesys dynamic stabilization (DDS). Consecutive patients who underwent 2- or 3-level DDS for spondylosis, recurrent disc herniations, or low-grade spondylolisthesis at L3-5 were retrospectively reviewed. BMD was assessed by the Hounsfield Unit (HU) in vertebral bodies (VB) and pedicles with and without cortical bone (CB) on pre-operative computed tomography (CT). Screw loosening was assessed by radiographs and confirmed by CT. HU values were compared between the loosened and intact screws. 176 patients and 918 screws were analyzed with 78 loosened screws found in 36 patients (mean follow-up: 43.4 months). The HU values of VB were similar in loosened and intact screws (p = 0.14). The HU values of pedicles were insignificantly less in loosened than intact screws (including CB: 286.70 ± 118.97 vs. 297.31 ± 110.99, p = 0.45; excluding CB: 238.48 ± 114.90 vs. 240.51 ± 108.91, p = 0.88). All patients had clinical improvements. In conclusion, the HU values, as a surrogate for BMD, were unrelated to screw loosening in DDS. Therefore, patients with compromised BMD might be potential candidates for dynamic stabilization rather than fusion.
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影响因子：
3.3
作者：
Booz, Christian;Noeske, Jochen;Wichmann, Julian L.
通讯作者：
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影响因子：
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作者：
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