Surgical treatment of osteoporotic thoraco-lumbar compressive fractures: the use of pedicle screw with augmentation PMMA.
The osteoporosis prevalence in population is age related. The aim of this single-center observational study was evaluate the middle- to long-term performance of cement (PMMA) augmented fenestrated pedicle screws in elderly patients with thoraco-lumbar compressive fractures by osteoporosis.



From 2011 to 2015 we treated 52 patients (20 males and 32 females) suffering from somatic osteoporotic fractures (T10-L2). The average age was 73.4 years, with an age range between 65 and 82 years. The treatment consisted of stabilization with pedicle screw augmentation with PMMA cement. Patients were clinically evaluated with Visual Analyzing System scale (VAS scale) and with low back disability questionnaire Oswestry, in pre and post surgery and during the follow up at 12 and 24 months.



A total of 410 fenestrated pedicle screws with PMMA augmentation were implanted. No cases of loosening or pulling out of screws were recorded. There have been n 3 cases of thrombophlebitis, treated with oral anticoagulant drugs and 1 case of post-operative death due to ventricular fibrillation. No neurological complications occurred during the study. The mean VAS score decreased from 8.5 to 4.8 and the result remained stable during follow up. Oswestry questionnaire showed a mean decrease of low back pain of 24% in post-op period.



Fenestrated screws with PMMA augmentation offers a possibility to treat patients with reduced bone quality due to severe osteoporosis.
Spine Surgery, AOU Città della Salute e della Scienza di Torino, Via Zuretti 29, 10126, Turin, Italy. massimogirardo@libero.it.
Massimo
0000-0002-6538-9294
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Girardo
Spine Surgery, AOU Città della Salute e della Scienza di Torino, Via Zuretti 29, 10126, Turin, Italy.
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Cinnella
Spine Surgery, AOU Città della Salute e della Scienza di Torino, Via Zuretti 29, 10126, Turin, Italy.
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G
Gargiulo
Spine Surgery, AOU Città della Salute e della Scienza di Torino, Via Zuretti 29, 10126, Turin, Italy.
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P
Viglierchio
Scuola di Specializzazione in Ortopedia e Traumatologia, Università degli Studi di Torino, Turin, Italy.
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A
Rava
Spine Surgery, AOU Città della Salute e della Scienza di Torino, Via Zuretti 29, 10126, Turin, Italy.
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S
Aleotti
D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D050815:Fractures, Compression; D006801:Humans; D008159:Lumbar Vertebrae / Q000601:surgery*; D008297:Male; D058866:Osteoporotic Fractures / Q000601:surgery*; D065289:Pedicle Screws; D019904:Polymethyl Methacrylate; D016103:Spinal Fractures / Q000601:surgery*; D013904:Thoracic Vertebrae / Q000601:surgery*; D016896:Treatment Outcome
D019904:Polymethyl Methacrylate
Fenestrated pedicle screws; Fractures; Osteoporosis