Intravertebral polymethylmethacrylate augmentation of anterior cervical discectomy fusion and plating in the setting of osteoporosis
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عنوان: Intravertebral polymethylmethacrylate augmentation of anterior cervical discectomy fusion and plating in the setting of osteoporosis
نویسندگان:
Oppenlander ME1, Bina R, Snyder LA, Dickman CA
1: Division of Neurological Surgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, AZ.
نشریه: Journal of spinal disorders & techniques
انتشارات: Wolters Kluwer Health | Lippincott Williams & Wilkins
تاریخ انتشار: 2014-05-01
کد مقاله: 01060407
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چکیده:
STUDY DESIGN:
Case report and review of the literature.
OBJECTIVE:
The aim of this study was to describe a novel approach for anterior cervical fixation, which uses cement augmentation in a patient withosteoporosis.
SUMMARY OF BACKGROUND DATA:
Osteoporotic bone presents a challenge for the treating spine surgeon, and techniques to overcome the difficulty of cervical spine fixation in these patients are lacking.
METHODS:
A 75-year-old woman with osteoporosis presented with cervical myelopathy and was found to have multiple-level cervical stenosis and C3-4 degenerative instability. The patient underwent anterior cervical discectomy fusion and plating from C3-7, with vertebroplastypolymethylmethacrylate augmentation through the screw pilot holes. Because of the patient's grossly soft bone, she also underwent postoperative halo placement.
RESULTS:
No cement extravasation was observed. The halo was removed after 3 months. At 6 months follow-up, the patient had full resolution of her myelopathy. Imaging showed the cervical interbody fusions to be healed at all levels, with no screw pullout or graft subsidence.
CONCLUSIONS:
This represents the first comprehensive description of successful cement augmentation during anterior cervical discectomy fusionand plating in a patient with osteoporosis, accomplishing both an increase in screw pullout strength and a decreased likelihood of graft subsidence. With further study, this technique may represent a viable treatment option in patients with osteoporosis requiring cervical decompression and fusion.
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