Instrumentation of the osteoporotic spine: Biomechanical and clinical considerations

Spine Journal

Volumn 11, Issue 1, 2011, Pages 54-63

  Ponnusamy, Karthikeyan E ^a   Iyer, Sravisht ^b   Gupta, Gaurav ^a   Khanna, A Jay ^c,d  

^a STANFORD UNIVERSITY SCHOOL OF MEDICINE   (United States)

^b HARVARD MEDICAL SCHOOL   (United States)

^c JOHNS HOPKINS UNIVERSITY SCHOOL OF MEDICINE   (United States)

^d JOHNS HOPKINS HOSPITAL   (United States)

Author keywords

anterior approaches; instrumentation; Osteoporosis; pedicle screws; vertebral augmentation; vertebral compression fractures

Indexed keywords

BIOMATERIAL; BISPHENOL A BIS(2 HYDROXYPROPYL) ETHER DIMETHACRYLATE; CALCIUM PHOSPHATE; CALCIUM SODIUM PHOSPHOSILICATE; HYDROXYAPATITE; POLY(METHYL METHACRYLATE); UNCLASSIFIED DRUG;

BIOMECHANICS; HUMAN; INCIDENCE; INSTRUMENTATION; NONHUMAN; OSTEOPOROSIS; PEDICLE SCREW; PERCUTANEOUS VERTEBROPLASTY; PRIORITY JOURNAL; REOPERATION; REVIEW; RISK REDUCTION; SPINE MALFORMATION; SPINE STABILIZATION; SURGICAL APPROACH; SURGICAL INSTRUMENT; SURGICAL RISK; SURGICAL TECHNIQUE; TREATMENT INDICATION; VERTEBRA FRACTURE;

HUMANS; OSTEOPOROSIS; OSTEOPOROTIC FRACTURES; SPINAL FRACTURES; SPINAL FUSION; SPINE;

EID: 78650294275     PISSN: 15299430     EISSN: None     Source Type: Journal    
DOI: 10.1016/j.spinee.2010.09.024     Document Type: Review

References (105)

1. S.L. Bonnick Osteoporosis in men and women Clin Cornerstone 8 2006 28 39
2. A. Kilbanski, L. Adams-Campbell, and T. Bassford Osteoporosis prevention, diagnosis, and therapy J Am Med Assoc 285 2001 785 795 (Pubitemid 32167238)
3. National Osteoporosis Foundation Fast facts on osteoporosis Available at http://med-docs.creighton.edu/images/Creighton-FIRST/Osteo-Spotlight/Fast-Facts. pdf Published July 2005. Accessed November 2, 2010
4. R. Burge, B. Dawson-Hughes, and D.H. Solomon Incidence and economic burden of osteoporosis-related fractures in the United States, 2005-2025 J Bone Miner Res 22 2007 465 475 (Pubitemid 46797130)
5. L.J. Melton III, A.W. Lane, and C. Cooper Prevalence and incidence of vertebral deformities Osteoporos Int 3 1993 113 119 (Pubitemid 23125371)
6. T.S. Keller, D.E. Harrison, and C.J. Colloca Prediction of osteoporotic spinal deformity Spine 28 2003 455 462
7. P.F. Heini The current treatment - a survey of osteoporotic fracture treatment. Osteoporotic spine fractures: the spine surgeon's perspective Osteoporos Int 16 2005 S85 S92
8. W.J. Kim, E.S. Lee, S.H. Jeon, and I. Yalug Correction of osteoporotic fracture deformities with global sagittal imbalance Clin Orthop Relat Res 443 2006 75 93 (Pubitemid 44324937)
9. C.J. DeWald, and T. Stanley Instrumentation-related complications of multilevel fusions for adult spinal deformity patients over age 65. Surgical considerations and treatment options in patients with poor bone quality Spine 31 2006 S144 S151 (Pubitemid 44337837)
10. B. Jost, P.A. Cripton, and T. Lund Compressive strength of interbody cages in the lumbar spine: the effect of cage shape, posterior instrumentation and bone density Eur Spine J 7 1998 132 141 (Pubitemid 28223599)
11. J.D. Coe, K.E. Warden, M.A. Herzig, and P.C. McAfee Influence of bone mineral density on the fixation of thoracolumbar implants. A comparative study of transpedicular screws, laminar hooks, and spinous process wires Spine 15 1990 902 907
12. C.N. Cornell Internal fracture fixation in patients with osteoporosis J Am Acad Orthop Surg 11 2003 109 119
13. S.G. Gilbert, P.C. Johns, D.C. Chow, and R.C. Black Relation of vertebral bone screw axial pullout strength to quantitative computed tomographic trabecular bone mineral content J Spinal Disord 6 1993 513 521
14. P.W. Hitchon, M.D. Brenton, and J.K. Coppes Factors affecting the pullout strength of self-drilling and self-tapping anterior cervical screws Spine 28 2003 9 13
15. D.J. Burval, R.F. McLain, R. Milks, and S. Inceoglu Primary pedicle screw augmentation in osteoporotic lumbar vertebrae. Biomechanical analysis of pedicle fixation strength Spine 32 2007 1077 1083 (Pubitemid 46685984)
16. J.P. Grant, T.R. Oxland, M.F. Dvorak, and C.G. Fisher The effects of bone density and disc degeneration on the structural property distributions in the lower lumbar vertebral endplates J Orthop Res 20 2002 1115 1120
17. T.H. Lim, H. Kwon, and C.H. Jeon Effect of endplate conditions and bone mineral density on the compressive strength of the graft-endplate interface in anterior cervical spine fusion Spine 26 2001 951 956 (Pubitemid 32373984)
18. T. Steffen, A. Tsantrizos, and M. Aebi Effect of implant design and endplate preparation on the compressive strength of interbody fusion constructs Spine 25 2000 1077 1084 (Pubitemid 30317188)
19. P.D. Delmas, L. van de Langerijt, and N.B. Watts Underdiagnosis of vertebral fractures is a worldwide problem: the IMPACT study J Bone Miner Res 20 2005 557 563
20. M. Gass, and B. Dawson-Hughes Preventing osteoporosis-related fractures: an overview Am J Med 119 2006 S3 S11
21. K. Lippuner Medical treatment of vertebral osteoporosis Eur Spine J 12 2003 S132 S141 (Pubitemid 37409930)
22. C.J. Rosen Clinical practice. Postmenopausal osteoporosis N Engl J Med 353 2005 595 603
23. L.B. Babat, R. McLain, and R. Milks The effects of the antiresorptive agents calcitonin and pamidronate on spine fusion in a rabbit model Spine J 5 2005 542 547 (Pubitemid 41258623)
24. R.A. Lehman Jr., A.E. Dmitriev, and M.J. Cardoso Effect of teriparatide [rhPTH(1,34)] and calcitonin on intertransverse process fusion in a rabbit model Spine 35 2010 146 152
25. R.A. Lehman Jr., T.R. Kuklo, and B.A. Freedman The effect of alendronate sodium on spinal fusion: a rabbit model Spine J 4 2004 36 43
26. A.R. Gezici, R. Ergun, and K. Gurel The effect of risedronate on posterior lateral spinal fusion in a rat model J Korean Neurosurg Soc 46 2009 45 51
27. R. Bransford, E. Goergens, and J. Briody Effect of zoledronic acid in an L6-L7 rabbit spine fusion model Eur Spine J 16 2007 557 562 (Pubitemid 46626249)
28. R.M. Neer, C.D. Arnaud, and J.R. Zanchetta Effect of parathyroid hormone (1-34) on fractures and bone mineral density in postmenopausal women with osteoporosis N Engl J Med 344 2001 1434 1441 (Pubitemid 32402100)
29. S.S. Hu Internal fixation in the osteoporotic spine Spine 22 1997 43S 48S
30. B.K. Kwon, H. Elgafy, and O. Keynan Progressive junctional kyphosis at the caudal end of lumbar instrumented fusion: etiology, predictors, and treatment Spine 31 2006 1943 1951 (Pubitemid 44297774)
31. E.G. Dawson, C.J. DeWald, and A. Nattiv Osteoporosis: evaluation and pharmacologic treatment R.L. DeWald, V. Arlet, A.L. Carl, M.F. O'Brien, Spinal deformities: the comprehensive text 2003 Thieme New York, NY 195 199
32. K. Tsuchiya, K.H. Bridwell, and T.R. Kuklo Minimum 5-year analysis of L5-S1 fusion using sacropelvic fixation (bilateral S1 and iliac screws) for spinal deformity Spine 31 2006 303 308 (Pubitemid 43214771)
33. T.L. Halvorson, L.A. Kelley, and K.A. Thomas Effects of bone mineral density on pedicle screw fixation Spine 19 1994 2415 2420 (Pubitemid 24347176)
34. K. Hasegawa, H.E. Takahashi, and S. Uchiyama An experimental study of a combination method using a pedicle screw and laminar hook for the osteoporotic spine Spine 22 1997 958 962 (Pubitemid 27203485)
35. J.Y. Margulies, R.S. Casar, and S.A. Caruso The mechanical role of laminar hook protection of pedicle screws at the caudal end vertebra Eur Spine J 6 1997 245 248
36. J.S. Tan, B.K. Kwon, and M.F. Dvorak Pedicle screw motion in the osteoporotic spine after augmentation with laminar hooks, sublaminar wires, or calcium phosphate cement: a comparative analysis Spine 29 2004 1723 1730
37. O. Linhardt, C. Luring, and J. Matussek Stability of anterior vertebral body screws after kyphoplasty augmentation. An experimental study to compare anterior vertebral body screw fixation in soft and cured kyphoplasty cement Int Orthop 30 2006 366 370 (Pubitemid 44284151)
38. K.D.K. Luk, L. Chen, and W.W. Lu A stronger bicortical sacral pedicle screw fixation through the s1 endplate. An in vitro cyclic loading and pull-out force evaluation Spine 30 2005 525 529 (Pubitemid 40293839)
39. M.P.G. Bostrom, and J.M. Lane Future directions. Augmentation of osteoporotic vertebral bodies Spine 22 1997 38S 42S
40. I.H. Lieberman, D. Togawa, and M.M. Kayanja Vertebroplasty and kyphoplasty: filler materials Spine J 5 2005 305S 316S (Pubitemid 41700076)
41. D.B. Pateder, A.J. Khanna, and I.H. Lieberman Vertebroplasty and kyphoplasty for the management of osteoporotic vertebral compression fractures Orthop Clin North Am 38 2007 409 418 (Pubitemid 47049642)
42. J.S. Sarzier, A.J. Evans, and D.W. Cahill Increased pedicle screw pullout strength with vertebroplasty augmentation in osteoporotic spines J Neurosurg Spine 96 2002 309 312
43. S. Tomita, S. Molloy, and L.E. Jasper Biomechanical comparison of kyphoplasty with different bone cements Spine 29 2004 1203 1207 (Pubitemid 38691980)
44. M. Aydogan, C. Ozturk, and O. Karatoprak The pedicle screw fixation with vertebroplasty augmentation in the surgical treatment of the severe osteoporotic spines J Spinal Disord Tech 22 2009 444 447
45. C. Yilmaz, B. Atalay, H. Caner, and N. Altinors Augmentation of a loosened sacral pedicle screw with percutaneous polymethylmethacrylate injection J Spinal Disord Tech 19 2006 373 375 (Pubitemid 44284116)
46. J.C.J. Webb, and R.F. Spencer The role of polymethylmethacrylate bone cement in modern orthopaedic surgery J Bone Joint Surg Br 89 2007 851 857
47. R.P. del Real, E. Ooms, and J.G.C. Wolke In vivo bone response to porous calcium phosphate cement J Biomed Mater Res A 65 2003 30 36 (Pubitemid 37517282)
48. A. Hoshikawa, N. Fukui, and A. Fukuda Quantitative analysis of the resorption and osteoconduction process of a calcium phosphate cement and its mechanical effect for screw fixation Biomaterials 24 2003 4967 4975 (Pubitemid 37237627)
49. S. Larsson Cement augmentation in fracture treatment Scand J Surg 95 2006 111 118 (Pubitemid 43886196)
50. C.H. Tsai, R.M. Lin, C.P. Ju, and J.H. Chern Lin Bioresorption behavior of tetracalcium phosphate-derived calcium phosphate cement implanted in femur of rabbits Biomaterials 29 2008 984 993
51. E.M. Erbe, T.D. Clineff, and G. Gualtieri Comparison of a new bisphenol-a-glycidyl dimethacrylate-based cortical bone void filler with polymethyl methacrylate Eur Spine J 10 2001 S147 S152 (Pubitemid 33009315)
52. H. Kobayashi, A.S. Turner, and H.B. Seim III Evaluation of a silica-containing bone graft substitute in a vertebral defect model J Biomed Mater Res A 92 2010 596 603
53. D.L. Wheeler, L.G. Jenis, and M.E. Kovach Efficacy of silicated calcium phosphate graft in posterolateral lumbar fusion in sheep Spine J 7 2007 308 317
54. J. Charnley Anchorage of the femoral head prosthesis to the shaft of the femur J Bone Joint Surg Br 42 1960 28 30
55. J. Charnley The bonding of prostheses to bone by cement J Bone Joint Surg Br 46 1964 518 529
56. J. Charnley A biomechanical analysis of the use of cement to anchor the femoral head prosthesis J Bone Joint Surg Br 47 1965 354 363
57. S.D. Cook, S.L. Salkeld, and T. Stanley Biomechanical study of pedicle screw fixation in severely osteoporotic bone Spine J 4 2004 402 408 (Pubitemid 38986981)
58. B.M. Frankel, S. D'Agostino, and C. Wang A biomechanical cadaveric analysis of polymethylmethacrylate-augmented pedicle screw fixation J Neurosurg Spine 7 2007 47 53 (Pubitemid 47071757)
59. O. Linhardt, C. Luring, and J. Matussek Stability of pedicle screws after kyphoplasty augmentation. An experimental study to compare transpedicular screw fixation in soft and cured kyphoplasty cement J Spinal Disord Tech 19 2006 87 91 (Pubitemid 44284151)
60. B. Bai, F.J. Kummer, and J. Spivak Augmentation of anterior vertebral body screw fixation by an injectable, biodegradable calcium phosphate bone substitute Spine 26 2001 2679 2683 (Pubitemid 34019755)
61. D.C. Moore, R.S. Maitra, and L.A. Farjo Restoration of pedicle screw fixation with an in situ setting calcium phosphate cement Spine 22 1997 1696 1705
62. H. Mutsuzaki, A. Ito, and M. Sakane Calcium phosphate coating formed in infusion fluid mixture to enhance fixation strength of titanium screws J Mater Sci Mater Med 18 2007 1799 1808 (Pubitemid 47222992)
63. S.M. Renner, T.H. Lim, and W.J. Kim Augmentation of pedicle screw fixation strength using an injectable calcium phosphate cement as a function of injection timing and method Spine 29 2004 E212 E216
64. M. Yazu, A. Kin, and R. Kosaka Efficacy of novel-concept pedicle screw fixation augmented with calcium phosphate cement in the osteoporotic spine J Orthop Sci 10 2005 56 61 (Pubitemid 40193009)
65. C.S. Chen, W.J. Chen, and C.K. Cheng Failure analysis of broken pedicle screws on spinal instrumentation Med Eng Phys 27 2005 487 496
66. G.S. Andreassen, P.R. Hoiness, and I. Skraamm Use of a synthetic bone void filler to augment screws in osteopenic ankle fracture fixation Arch Orthop Trauma Surg 124 2004 161 165 (Pubitemid 38559263)
67. R.S. Smit, D. van der Velde, and J.H. Hegeman Augmented pin fixation with Cortoss for an unstable AO-A3 type distal radius fracture in a patient with a manifest osteoporosis Arch Orthop Trauma Surg 128 2008 989 993
68. I. Ergur, O. Akcali, and A. Kiray Neurovascular risks of sacral screws with bicortical purchase: an anatomical study Eur Spine J 16 2007 1519 1523 (Pubitemid 47389499)
69. S.I. Esses, D.J. Botsford, R.J. Huler, and W. Rauschning Surgical anatomy of the sacrum. A guide for rational screw fixation Spine 16 1991 S283 S288
70. N.J. Licht, D.E. Rowe, and L.M. Ross Pitfalls of pedicle screw fixation in the sacrum. A cadaver model Spine 17 1992 892 896
71. R.A. Lehman Jr., T.R. Kuklo, and P.J. Belmont Jr. Advantage of pedicle screw fixation directed into the apex of the sacral promontory over bicortical fixation: a biomechanical analysis Spine 27 2002 806 811
72. J.G. Heller, B.T. Estes, M. Zaouali, and A. Diop Biomechanical study of screws in the lateral masses: variables affecting pull-out resistance J Bone Joint Surg Am 78 1996 1315 1321 (Pubitemid 26336881)
73. M.R. Zindrick, L.L. Wiltse, and E.H. Widell A biomechanical study of intrapeduncular screw fixation in the lumbosacral spine Clin Orthop Relat Res 203 1986 99 112 (Pubitemid 16115318)
74. R.W. Gaines Jr. The use of pedicle-screw internal fixation for the operative treatment of spinal disorders J Bone Joint Surg Am 82 2000 1458 1476
75. O.S. Yildirim, B. Aksakal, and S.C. Hanyaloglu Hydroxyapatite dip coated and uncoated titanium poly-axial pedicle screws: an in vivo bovine model Spine 31 2006 E215 E220
76. S.I. Chen, R.M. Lin, and C.H. Chang Biomechanical investigation of pedicle screw-vertebrae complex: a finite element approach using bonded and contact interface conditions Med Eng Phys 25 2003 275 282
77. M. Fini, G. Giavaresi, and T. Greggi Biological assessment of the bone-screw interface after insertion of uncoated and hydroxyapatite-coated pedicular screws in the osteopenic sheep J Biomed Mater Res A 66 2003 176 183 (Pubitemid 37517263)
78. D. Deligianni, P. Korovessis, M.C. Porte-Derrieu, and J. Amedee Fibronectin preadsorbed on hydroxyapatite together with rough surface structure increases osteoblasts' adhesion "in vitro": the theoretical usefulness of fibronectin preadsorption on hydroxyapatite to increase permanent stability and longevity in spine implants J Spinal Disord Tech 18 2005 257 262 (Pubitemid 43085863)
79. N.N. Aldini, M. Fini, and G. Giavaresi Pedicular fixation in the osteoporotic spine: a pilot in vivo study on long-term ovariectomized sheep J Orthop Res 20 2002 1217 1224 (Pubitemid 35369978)
80. T. Hasegawa, A. Inufusa, and Y. Imai Hydroxyapatite-coating of pedicle screws improves resistance against pull-out force in the osteoporotic canine lumbar spine model: a pilot study Spine J 5 2005 239 243 (Pubitemid 40613663)
81. B. Sanden, C. Olerud, C. Johansson, and S. Larsson Improved extraction torque of hydroxyapatite-coated pedicle screws Eur Spine J 9 2000 534 537 (Pubitemid 32005658)
82. B. Sanden, C. Olerud, M. Petren-Mallmin, and S. Larsson Hydroxyapatite coating improves fixation of pedicle screws. A clinical study J Bone Joint Surg Br 84 2002 387 391 (Pubitemid 34413769)
83. L. Jiang, V. Arlet, L. Beckman, and T. Steffen Double pedicle screw instrumentation in the osteoporotic spine. A biomechanical feasibility study J Spinal Disord Tech 20 2007 430 435 (Pubitemid 47357500)
84. B.B. Ngu, S.M. Belkoff, D.E. Gelb, and S.C. Ludwig A biomechanical comparison of sacral pedicle screw salvage techniques Spine 31 2006 E166 E168
85. S.D. Cook, J. Barbera, and M. Rubi Lumbosacral fixation using expandable pedicle screws: an alternative in reoperation and osteoporosis Spine J 1 2001 109 114 (Pubitemid 33628833)
86. S.D. Cook, S.L. Salkeld, T.S. Whitecloud III, and J. Barbera Biomechanical testing and clinical experience with the OMEGA-21 spinal fixation system Am J Orthop 30 2001 387 394
87. A. Kettler, W. Schmoelz, and Y. Shezifi Biomechanical performance of the new BeadEx implant in the treatment of osteoporotic vertebral body compression fractures: restoration and maintenance of height and stability Clin Biomech (Bristol, Avon) 21 2006 676 682 (Pubitemid 43963196)
88. M. Reinhold, K. Schwieger, and J. Goldhahn Influence of screw positioning in a new anterior spine fixator on implant loosening in osteoporotic vertebrae Spine 31 2006 406 413 (Pubitemid 43361738)
89. S.J. Ferguson, F. Winkler, and L.P. Nolte Anterior fixation in the osteoporotic spine: cut-out and pullout characteristics of implants Eur Spine J 11 2002 527 534 (Pubitemid 35435862)
90. J. Goldhahn, D. Neuhoff, and S. Schaeren Osseointegration of hollow cylinder based spinal implants in normal and osteoporotic vertebrae: a sheep study Arch Orthop Trauma Surg 126 2006 554 561 (Pubitemid 44473282)
91. J. Goldhahn, M. Reinhold, and M. Stauber Improved anchorage in osteoporotic vertebrae with new implant designs J Orthop Res 24 2006 917 925 (Pubitemid 43804926)
92. I.H. Lieberman, R. Khazim, and T. Woodside Anterior vertebral body screw pullout testing: a comparison of Zeilke, Kaneda, Universal Spine System, and Universal Spine System with pullout-resistant nut Spine 23 1998 908 910 (Pubitemid 28188919)
93. J.R. Chapman, R.M. Harrington, and K.M. Lee Factors affecting the pullout strength of cancellous bone screws J Biomech Eng 118 1996 391 398
94. S.W. Breeze, B.J. Doherty, and P.S. Noble A biomechanical study of anterior thoracolumbar screw fixation Spine 23 1998 1829 1831 (Pubitemid 28432477)
95. J.M. Spivak, D. Chen, and F.J. Kummer The effect of locking fixation screws on the stability of anterior cervical plating Spine 24 1999 334 338 (Pubitemid 29101942)
96. T.J. Huang, R.W.W. Hsu, C.L. Tai, and W.P. Chen A biomechanical analysis of triangulation of anterior vertebral double-screw fixation Clin Biomech (Bristol, Avon) 18 2003 S40 S45
97. J.D. Clausen, T.C. Ryken, and V.C. Traynelis Biomechanical evaluation of Caspar and Cervical Spine Locking Plate systems in a cadaveric model J Neurosurg 84 1996 1039 1045
98. K. Das, W.T. Couldwell, G. Sava, and R.F. Taddonio Use of cylindrical titanium mesh and locking plates in anterior cervical fusion. Technical note J Neurosurg 94 2001 174 178 (Pubitemid 32799731)
99. J.P. Kostuik, P.J. Connolly, S.I. Esses, and P. Suh Anterior cervical plate fixation with the titanium hollow screw plate system Spine 18 1993 1273 1278 (Pubitemid 23252315)
100. K. Uchida, S. Kobayashi, and H. Nakajima Anterior expandable strut cage replacement for osteoporotic thoracolumbar vertebral collapse J Neurosurg Spine 4 2006 454 462 (Pubitemid 47325429)
101. H. Baba, Y. Maezawa, and K. Kamitani Osteoporotic vertebral collapse with late neurological complications Paraplegia 33 1995 281 289
102. H.H. Mathews, M.T. Evans, H.J. Molligan, and B.H. Long Laparoscopic discectomy with anterior lumbar interbody fusion. A preliminary review Spine 20 1995 1797 1802
103. K. Ponnusamy, S. Chewning, and C. Mohr Robotic approaches to the posterior spine Spine 34 2009 2104 2109
104. B.T. Ragel, A. Amini, and M.H. Schmidt Thoracoscopic vertebral body replacement with an expandable cage after ventral spinal canal decompression Neurosurgery 61 2007 317 322 discussion 322-3 (Pubitemid 350306849)
105. J.F. Zucherman, T.A. Zdeblick, and S.A. Bailey Instrumented laparoscopic spinal fusion. Preliminary results Spine 20 1995 2029 2034