Low occupancy rate of the pedicle screw in the vertebral body leads to upper instrumented vertebral fracture.
Age Factors
Aged
Bone Density
/ drug effects
Comorbidity
Diabetes Mellitus
/ drug therapy
Female
Follow-Up Studies
Humans
Hypoglycemic Agents
/ adverse effects
Male
Middle Aged
Pedicle Screws
/ adverse effects
Postoperative Complications
/ diagnosis
Retrospective Studies
Risk Factors
Spinal Fractures
/ diagnosis
Spinal Fusion
/ adverse effects
Tomography, X-Ray Computed
Vertebral Body
/ diagnostic imaging
Journal
Scientific reports
ISSN: 2045-2322
Titre abrégé: Sci Rep
Pays: England
ID NLM: 101563288
Informations de publication
Date de publication:
24 06 2020
24 06 2020
Historique:
received:
30
09
2019
accepted:
05
06
2020
entrez:
26
6
2020
pubmed:
26
6
2020
medline:
22
12
2020
Statut:
epublish
Résumé
Upper instrumented vertebra (UIV) fracture in adult spinal deformity surgery leads serious complications, such as spinal cord injury in 0.5-0.8%. Although tip-apex distance is important for preventing screw cut-out in proximal femoral fracture surgery, this suggest that the screw occupancy rate for bone fragments is also important. The purpose of this study was to investigate how the occupancy rate of pedicle screws (ORPS) affects UIV fracture. Patients with UIV fracture 1 year after surgery were defined as the fracture group (F); others were defined as the no fracture group (NF). ORPS, cut-out of pedicle screw (PS), medications, and bone mineral density were evaluated. Significant differences (P < 0.05) between group F (n = 58) and group NF (n = 260) were observed in age (71 years old in group F and 65 years old in group NF), diabetes medication use (19% in group F and 4% in group NF), steroid drug use (10% in group F and 2% in group NF), and ORPS (70% in group F and 76% in group NF). The cut-off value of ORPS using receiver operator characteristic analysis was 73%. Multiple logistic regression analysis identified diabetes medication use (P = 0.026, odds ratio [OR] 4.0) and ORPS < 73% (P = 0.001, OR 3.6) as significant risk factors for UIV fracture. The surgeon can't control use of diabetes medication. However, they can replace with longer PS when ORPS < 73% is detected on radiographs taken during surgery. Further studies will be needed to better elucidate it's use.
Identifiants
pubmed: 32581234
doi: 10.1038/s41598-020-67337-3
pii: 10.1038/s41598-020-67337-3
pmc: PMC7314840
doi:
Substances chimiques
Hypoglycemic Agents
0
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
10270Références
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