Hajilo Parisa, Imani Behzad, Zandi Shirdel, Mehrafshan Ali
Student Operating Room (MSc), Student Research Committee, Hamadan University of Medical Sciences, Hamadan, Iran.
Department of Operating Room, School of Paramedicine, Hamadan University of Medical Sciences, Hamadan, Iran.
Sci Rep. 2025 Feb 12;15(1):5226. doi: 10.1038/s41598-024-80845-w.
The biggest challenge for osteoporotic patients after spinal stabilization is screw loosening. Therefore, the present study was conducted with the comparative aim of stabilizing the lumbar spine with 2-stage surgery and cement augmentation in osteoporotic patients. 66 patients selected through convenience sampling and randomly assigned to two groups: CAPS and 2-stage surgery. In the CAPS group, lumbar spine fixation was performed in a single stage, accompanied by cement augmentation. In the 2-stage surgery group, spinal stabilization was conducted in 2 stages. In the first stage, pedicle screws were implanted, followed by the pedicle screw anchoring process 6 months later. fusion rate, screw loosening, pain levels (VAS), and patients' disability (ODI) were measured in each group. The fusion rate in the 2-stage Surgery group significantly increased. Screw loosening in the CAPS group showed a significantly higher difference. The rate of pain and disability in patients early postoperatively, in comparison to preoperative measures, significantly decreased in both groups. In the final follow-up, the CAPS group experienced a significant increase in pain and disability. The 2-stage Surgery stabilization, when compared to the CAPS technique, demonstrates superiority in enhancing the biomechanical stability of screws and achieving successful fusion.
脊柱稳定术后骨质疏松患者面临的最大挑战是螺钉松动。因此,本研究旨在对比两阶段手术联合骨水泥强化与单阶段手术对骨质疏松患者腰椎进行稳定的效果。通过便利抽样选取66例患者,并随机分为两组:CAPS组和两阶段手术组。在CAPS组中,腰椎固定在一个阶段完成,并伴有骨水泥强化。在两阶段手术组中,脊柱稳定分两个阶段进行。第一阶段植入椎弓根螺钉,6个月后进行椎弓根螺钉锚固。测量每组的融合率、螺钉松动情况、疼痛程度(视觉模拟评分法)和患者残疾程度(Oswestry功能障碍指数)。两阶段手术组的融合率显著提高。CAPS组的螺钉松动差异显著更高。与术前相比,两组患者术后早期的疼痛和残疾率均显著降低。在最终随访中,CAPS组的疼痛和残疾程度显著增加。与CAPS技术相比,两阶段手术稳定在增强螺钉生物力学稳定性和实现成功融合方面具有优越性。