Fractured vertebrae more susceptible to pedicle screw loosening: 3 study findings

Written by Shayna Korol | January 09, 2019 | Print  |

Among patients undergoing pedicle screw removal surgery, screws in fractured vertebrae or non-fusion surgeries were vulnerable to loosening, according to a study in the Journal of Orthopaedic Surgery and Research.

Pedicle screw loosening is a common postsurgical complication after spine procedures. Researchers evaluated 33 patients who underwent pedicle screw removal surgery at least two years after their primary surgery. Patients were preoperatively evaluated for fixation stability using X-rays and CT scans.  

Three findings:

1. In all, 236 screws were removed. The loosening rate was 33 percent.

2. The extraction torque of pedicle screws inserted in fractured vertebrae was significantly lower than in non-fractured vertebrae, p = 0.009; screws of non-fusion surgeries had lower extraction torque compared to those in fusion surgeries.

3. Both X-rays and CT scans had high specificity for screw loosening detection, but their sensitivities were relatively low. Surgeons need to be more diligent when assessing screw loosening based on radiological examination, study authors concluded.

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