Clinical application of a pedicle nail system with polymethylmethacrylate for osteoporotic vertebral fracture

Keiya Yamana, Masato Tanaka, Yoshihisa Sugimoto, Tomoyuki Takigawa, Toshihumi Ozaki, Hitoshi Konishi

Research output: Contribution to journalArticle

10 Citations (Scopus)

Abstract

The instrumentation of the osteoporotic spine may sometimes result in failure due to the loosening or pullout of the conventional pedicle screw. Moreover, augmentation of screws with polymethylmethacrylate (PMMA) has risks of complications. We developed a new and original pedicle nail system with PMMA for osteoporotic vertebral fractures. A clinical evaluation of this novel pedicle nail system utilized in patients with an osteoporotic vertebral collapse was performed to determine the effectiveness and safety of this technique. Thirty-four elderly patients who suffered from osteoporotic compression fractures were treated by posterolateral fusion using the pedicle nail system. The mean follow-up period was 37 months. Of the 25 patients with neurological symptoms, two patients improved two stages at the Frankel level. Fifteen patients improved one stage at the Frankel level, and eight other patients improved, however, their improvement did not exceed a Frankel level. Nine cases with neuralgia symptoms improved from 4.4 to 2.2 points on average on the Denis pain scale (p <0.01). The fusion rate was 94% as determined by X-rays of flexion and extension, and the correction of the compression fracture site was maintained well. A pedicle nail system stabilizes the spinal column with osteoporosis and reduces the instrumentation failure. The technique for the insertion of the pedicle nail reduces complication from cement augmentation. The authors speculate that the strategy using the pedicle nail system for osteoporotic spine may be effective and safe when the surgery is performed through a posterior approach.

Original languageEnglish
Pages (from-to)1643-1650
Number of pages8
JournalEuropean Spine Journal
Volume19
Issue number10
DOIs
Publication statusPublished - Oct 2010

Fingerprint

Osteoporotic Fractures
Polymethyl Methacrylate
Nails
Compression Fractures
Spine
Neuralgia
Osteoporosis
X-Rays
Safety
Pain

Keywords

  • Compression fracture
  • Osteoporosis
  • Pedicle screw
  • PMMA
  • Spinal fusion

ASJC Scopus subject areas

  • Surgery
  • Orthopedics and Sports Medicine

Cite this

Clinical application of a pedicle nail system with polymethylmethacrylate for osteoporotic vertebral fracture. / Yamana, Keiya; Tanaka, Masato; Sugimoto, Yoshihisa; Takigawa, Tomoyuki; Ozaki, Toshihumi; Konishi, Hitoshi.

In: European Spine Journal, Vol. 19, No. 10, 10.2010, p. 1643-1650.

Research output: Contribution to journalArticle

Yamana, Keiya ; Tanaka, Masato ; Sugimoto, Yoshihisa ; Takigawa, Tomoyuki ; Ozaki, Toshihumi ; Konishi, Hitoshi. / Clinical application of a pedicle nail system with polymethylmethacrylate for osteoporotic vertebral fracture. In: European Spine Journal. 2010 ; Vol. 19, No. 10. pp. 1643-1650.
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