Montoya Juan Esteban Muñoz, Díaz Antonio José Gómez, Cardozo José Leonardo Guerrero, Shetty Ajoy Prasad
Neurosurgeon, Universidad Militar Nueva Granada, Bogotá, Colombia.
Spine Fellowship, Ganga Hospital, Coimbatore, Tamil Nadu, India.
J Craniovertebr Junction Spine. 2025 Apr-Jun;16(2):133-141. doi: 10.4103/jcvjs.jcvjs_106_25. Epub 2025 Jul 3.
Pedicle screw augmentation with polymethylmethacrylate (PMMA) is a technique used to reduce the risk of pedicle screw pullout, loss of screw fixation, and implant failure in patients at high risk of mechanical complications.
This was a retrospective observational study.
The objective of this study was to describe a modification of the classic augmentation technique of conventional pedicular screw instrumentation in spinal surgery.
A retrospective analysis was performed on 47 patients over the age of 65 years who underwent spinal surgery using the proposed cement augmentation technique and were followed for 2 years. High-viscosity cement was injected into tapped vertebral pedicles, followed by the insertion of traditional pedicle screws. Patient selection was based on detailed preoperative clinical and imaging evaluations. Outcomes measured included the rate of complications, particularly cement leakage (CL), and the occurrence of neurological or vascular deficits.
A total of 47 patients were treated with 700 conventional screws. A total of 26/700 screws (3.71%) showed CL. According to the modified Yeom classification for CL, 9/700 (0.71%) were type S, 9/700 (0.71%) were type B, and 8/700 (0.57%) were type I; there were no neurological or vascular complications. There were no mechanical complications at 2 years.
This modified augmentation technique for conventional pedicle screws is an alternative for spinal instrumentation in elderly patients with a low incidence of clinically significant complications and also reduces procedure time by facilitating pedicle screw placement.
使用聚甲基丙烯酸甲酯（PMMA）进行椎弓根螺钉强化是一种用于降低机械并发症高风险患者椎弓根螺钉拔出、螺钉固定丧失和植入物失败风险的技术。
这是一项回顾性观察研究。
本研究的目的是描述脊柱手术中传统椎弓根螺钉器械经典强化技术的一种改良方法。
对47例65岁以上接受脊柱手术并采用所提出的骨水泥强化技术且随访2年的患者进行回顾性分析。将高粘度骨水泥注入攻丝后的椎弓根，随后插入传统椎弓根螺钉。患者选择基于详细的术前临床和影像学评估。测量的结果包括并发症发生率，特别是骨水泥渗漏（CL），以及神经或血管缺损的发生情况。
共47例患者接受了700枚传统螺钉治疗。共有26/700枚螺钉（3.71%）出现CL。根据改良的Yeom CL分类，9/700枚（0.71%）为S型，9/700枚（0.71%）为B型，8/700枚（0.57%）为I型；无神经或血管并发症。2年时无机械并发症。
这种改良的传统椎弓根螺钉强化技术是老年患者脊柱内固定的一种替代方法，临床显著并发症发生率低，并且通过便于椎弓根螺钉置入还可缩短手术时间。
