Shitozawa Hisakazu, Misawa Haruo, Oda Yoshiaki, Joko Ryoji, Takahashi Masaya, Uotani Koji, Shiozaki Yasuyuki, Tetsunaga Tomoko, Shinohara Kensuke, Nakamichi Ryo, Ueda Masataka, Takatori Ryo, Yamashita Kazutaka, Ozaki Toshifumi
Department of Orthopaedic Surgery, Science of Functional Recovery and Reconstruction, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, JPN.
Department of Orthopaedic Surgery, Ryusou Orthopaedic Hospital, Okayama, JPN.
Cureus. 2025 Jun 13;17(6):e85955. doi: 10.7759/cureus.85955. eCollection 2025 Jun.
We developed a cement-catching screw (CCS) technique for pedicle screw insertion into hardened cement, connecting anterior and posterior vertebral elements during balloon kyphoplasty (BKP) for osteoporotic vertebral fractures (OVFs). This study reports the CCS technique, clinical outcomes, and biomechanical properties.
This retrospective study included 59 patients (20 men, 39 women; mean age, 77.4 ± 8.7 years) who underwent BKP with one-above-one-below posterior fixation for OVFs between 2020 and 2023. Patients were divided into CCS (-) (without intermediate screws, n = 28) and CCS (+) (with intermediate CCSs, n = 31) groups. Clinical and radiographic outcomes, including activities of daily living, vertebral wedge angle (VWA), surgical level Cobb angle (CA), anterior vertebral body height (AVBH), screw loosening, pullout, and adjacent vertebral fractures, were evaluated preoperatively, postoperatively, and at the final follow-up (≥6 months). Biomechanical pullout strength was assessed at different insertion depths (5, 10, and 15 mm) using polymethylmethacrylate cement.
No significant differences were observed between groups in age, sex, follow-up duration, or blood loss; however, the operation time was significantly longer in the CCS (+) group than in the CCS (-) group (P < 0.0001). Radiographic outcomes showed no significant differences in the VWA, CA, AVBH, adjacent vertebral fracture rates, and reoperation rates. However, the incidence of adjacent pedicle screws loosening and pullout was significantly higher in the CCS (-) group than in the CCS (+) group (P = 0.046 and 0.0084, respectively). The correction loss of the CA was significantly lower in the CCS (+) group (CCS (-), 5.6° ± 4.8°; CCS (+), 3.5° ± 4.8°, P = 0.023). The biomechanical test revealed pullout strengths of 683 ± 164, 2231 ± 208, and 3477 ± 393 N for insertion depths of 5, 10, and 15 mm, respectively, with significant increases by depth (P = 0.003 and 0.009).
The CCS technique improves anterior-posterior vertebral body stability, enhances fixation strength, and contributes to better surgical outcomes in OVFs treatment.
我们开发了一种用于在球囊后凸成形术（BKP）治疗骨质疏松性椎体骨折（OVF）过程中将椎弓根螺钉插入硬化骨水泥、连接椎体前后部元件的骨水泥捕捉螺钉（CCS）技术。本研究报告了CCS技术、临床结果和生物力学特性。
这项回顾性研究纳入了2020年至2023年间接受BKP联合上下相邻节段后路固定治疗OVF的59例患者（20例男性，39例女性；平均年龄77.4±8.7岁）。患者分为CCS（-）组（无中间螺钉，n = 28）和CCS（+）组（有中间CCS螺钉，n = 31）。评估术前、术后及末次随访（≥6个月）时的临床和影像学结果，包括日常生活活动能力以及椎体楔角（VWA）、手术节段Cobb角（CA）、椎体前缘高度（AVBH）、螺钉松动、拔出及相邻椎体骨折情况。使用聚甲基丙烯酸甲酯骨水泥在不同插入深度（5、10和15 mm）评估生物力学拔出强度。
两组在年龄、性别、随访时间或失血量方面无显著差异；然而，CCS（+）组的手术时间显著长于CCS（-）组（P < 0.0001）。影像学结果显示，VWA、CA、AVBH、相邻椎体骨折率和再次手术率无显著差异。然而，CCS（-）组相邻椎弓根螺钉松动和拔出的发生率显著高于CCS（+）组（分别为P = 0.046和0.0084）。CCS（+）组CA的矫正丢失显著更低（CCS（-）组，5.6°±4.8°；CCS（+）组，3.5°±4.8°，P = 0.023）。生物力学测试显示，插入深度为5、10和15 mm时的拔出强度分别为683±164、2231±208和3477±393 N，随深度显著增加（P = 0.003和0.009）。
CCS技术可改善椎体前后稳定性，增强固定强度，并有助于在OVF治疗中获得更好的手术效果。
