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Time to augment?! Impact of cement augmentation on pedicle screw fixation strength depending on bone mineral density
Purpose Cement augmentation of pedicle screws is known to increase their mechanical strength. Aim was to evaluate the impact of cement augmentation on pedicle screw fatigue strength in dependence of the bone mineral density (BMD). Methods Twenty-one human L2 vertebral bodies from donors between 19 a...
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| Published in: | European spine journal 2018-08, Vol.27 (8), p.1964-1971 |
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| Main Authors: | , , , , , , |
| Format: | Article |
| Language: | English |
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| cited_by | cdi_FETCH-LOGICAL-c372t-10ed02fdeb01b9d4a608574aff6722645dabab48c600a79619362814b5ef7e423 |
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| cites | cdi_FETCH-LOGICAL-c372t-10ed02fdeb01b9d4a608574aff6722645dabab48c600a79619362814b5ef7e423 |
| container_end_page | 1971 |
| container_issue | 8 |
| container_start_page | 1964 |
| container_title | European spine journal |
| container_volume | 27 |
| creator | Weiser, Lukas Huber, Gerd Sellenschloh, Kay Viezens, Lennart Püschel, Klaus Morlock, Michael M. Lehmann, Wolfgang |
| description | Purpose
Cement augmentation of pedicle screws is known to increase their mechanical strength. Aim was to evaluate the impact of cement augmentation on pedicle screw fatigue strength in dependence of the bone mineral density (BMD).
Methods
Twenty-one human L2 vertebral bodies from donors between 19 and 96 years of age were used for in vitro experiments. BMD was measured using quantitative computed tomography (QCT). Two pedicle screws were inserted in each specimen and unilaterally augmented with bone cement. Fatigue testing was performed using a cranio-caudal sinusoidal, cyclic load (0.5 Hz) with increasing compression force (100 N + 0.1 N/cycles). Results were evaluated for the BMD groups: normal: BMD > 120 mg/cm
3
, osteopenic: BMD 80–120 mg/cm
3
, and osteoporotic: BMD |
| doi_str_mv | 10.1007/s00586-018-5660-7 |
| format | article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2060867509</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2060867509</sourcerecordid><originalsourceid>FETCH-LOGICAL-c372t-10ed02fdeb01b9d4a608574aff6722645dabab48c600a79619362814b5ef7e423</originalsourceid><addsrcrecordid>eNp1kV9L5TAQxYMo693rfgBflsi--FKdpGnSPC0i-0cQfNHnkLbTa6RNu0mK67ffXKouLCwEBnJ-c2aYQ8gpgwsGoC4jQFXLAlhdVFJCoQ7IhomSF6BLfkg2oAUUUjF9TD7G-ATAKg3yAznmWou65HxD0r0bkaaJ2mU3ok9fz-jNONs20amnLe6_3iSb3ORpfjN2rh2QxjbgM-3d71WJKaDfpUfa4Yy-c363h5vJIx2dx2CHrPjo0ssJOertEPHTa92Sh-_f7q9_Frd3P26ur26LtlQ8FQywA9532ABrdCeshLpSwva9VJxLUXW2sY2oWwlglZZMl5LXTDQV9goFL7fkfPWdw_RrwZjM6GKLw2A9Tks0HLKjVFU-15Z8-Qd9mpbg83aZqvIwVrMyU2yl2jDFGLA3c3CjDS-GgdlHYtZITI7E7CMxKvd8fnVemhG79463DDLAVyBmye8w_B39f9c_X9OW1g</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2052641813</pqid></control><display><type>article</type><title>Time to augment?! Impact of cement augmentation on pedicle screw fixation strength depending on bone mineral density</title><source>Springer Link</source><creator>Weiser, Lukas ; Huber, Gerd ; Sellenschloh, Kay ; Viezens, Lennart ; Püschel, Klaus ; Morlock, Michael M. ; Lehmann, Wolfgang</creator><creatorcontrib>Weiser, Lukas ; Huber, Gerd ; Sellenschloh, Kay ; Viezens, Lennart ; Püschel, Klaus ; Morlock, Michael M. ; Lehmann, Wolfgang</creatorcontrib><description>Purpose
Cement augmentation of pedicle screws is known to increase their mechanical strength. Aim was to evaluate the impact of cement augmentation on pedicle screw fatigue strength in dependence of the bone mineral density (BMD).
Methods
Twenty-one human L2 vertebral bodies from donors between 19 and 96 years of age were used for in vitro experiments. BMD was measured using quantitative computed tomography (QCT). Two pedicle screws were inserted in each specimen and unilaterally augmented with bone cement. Fatigue testing was performed using a cranio-caudal sinusoidal, cyclic load (0.5 Hz) with increasing compression force (100 N + 0.1 N/cycles). Results were evaluated for the BMD groups: normal: BMD > 120 mg/cm
3
, osteopenic: BMD 80–120 mg/cm
3
, and osteoporotic: BMD < 80 mg/cm
3
bone mass.
Results
There was a significant correlation between fatigue force and BMD for the non-augmented and augmented screws (non-augmented
R
2
= 0.839,
p
< 0.001; augmented
R
2
= 0.551,
p
< 0.001). There was a significantly increased fatigue strength of the augmented screws over the non-augmented screws in the osteoporotic group (
p
= 0.001), while the differences in the other groups were not significant (normal
p
= 0.818/osteopenic
p
= 0.132).
Conclusions
The benefit of pedicle screw cement augmentation significantly depends on the bone mineral density and has the greatest extent of increased fatigue strength in osteoporotic vertebrae. Preoperative measurement of the BMD is strongly recommended to predict the benefit of augmentation and reinforce the decision for cement augmentation.
Graphical abstract
These slides can be retrieved under Electronic Supplementary Material.</description><identifier>ISSN: 0940-6719</identifier><identifier>EISSN: 1432-0932</identifier><identifier>DOI: 10.1007/s00586-018-5660-7</identifier><identifier>PMID: 29948322</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Adult ; Aged ; Aged, 80 and over ; Biomechanical Phenomena - physiology ; Bone Cements - therapeutic use ; Bone density ; Bone Density - physiology ; Bone implants ; Bone mass ; Bone mineral density ; Cadaver ; Cement ; Compression ; Computed tomography ; Equipment Failure Analysis - methods ; Female ; Humans ; Lumbar Vertebrae - diagnostic imaging ; Lumbar Vertebrae - physiopathology ; Lumbar Vertebrae - surgery ; Male ; Materials Testing - methods ; Mechanical properties ; Medicine ; Medicine & Public Health ; Middle Aged ; Neurosurgery ; Original Article ; Osteoporosis ; Osteoporosis - diagnostic imaging ; Osteoporosis - physiopathology ; Pedicle Screws ; Prosthesis Failure ; Spine ; Surgical Orthopedics ; Tomography, X-Ray Computed ; Vertebrae ; Young Adult</subject><ispartof>European spine journal, 2018-08, Vol.27 (8), p.1964-1971</ispartof><rights>Springer-Verlag GmbH Germany, part of Springer Nature 2018</rights><rights>European Spine Journal is a copyright of Springer, (2018). All Rights Reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c372t-10ed02fdeb01b9d4a608574aff6722645dabab48c600a79619362814b5ef7e423</citedby><cites>FETCH-LOGICAL-c372t-10ed02fdeb01b9d4a608574aff6722645dabab48c600a79619362814b5ef7e423</cites><orcidid>0000-0001-9812-4658</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27903,27904</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/29948322$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Weiser, Lukas</creatorcontrib><creatorcontrib>Huber, Gerd</creatorcontrib><creatorcontrib>Sellenschloh, Kay</creatorcontrib><creatorcontrib>Viezens, Lennart</creatorcontrib><creatorcontrib>Püschel, Klaus</creatorcontrib><creatorcontrib>Morlock, Michael M.</creatorcontrib><creatorcontrib>Lehmann, Wolfgang</creatorcontrib><title>Time to augment?! Impact of cement augmentation on pedicle screw fixation strength depending on bone mineral density</title><title>European spine journal</title><addtitle>Eur Spine J</addtitle><addtitle>Eur Spine J</addtitle><description>Purpose
Cement augmentation of pedicle screws is known to increase their mechanical strength. Aim was to evaluate the impact of cement augmentation on pedicle screw fatigue strength in dependence of the bone mineral density (BMD).
Methods
Twenty-one human L2 vertebral bodies from donors between 19 and 96 years of age were used for in vitro experiments. BMD was measured using quantitative computed tomography (QCT). Two pedicle screws were inserted in each specimen and unilaterally augmented with bone cement. Fatigue testing was performed using a cranio-caudal sinusoidal, cyclic load (0.5 Hz) with increasing compression force (100 N + 0.1 N/cycles). Results were evaluated for the BMD groups: normal: BMD > 120 mg/cm
3
, osteopenic: BMD 80–120 mg/cm
3
, and osteoporotic: BMD < 80 mg/cm
3
bone mass.
Results
There was a significant correlation between fatigue force and BMD for the non-augmented and augmented screws (non-augmented
R
2
= 0.839,
p
< 0.001; augmented
R
2
= 0.551,
p
< 0.001). There was a significantly increased fatigue strength of the augmented screws over the non-augmented screws in the osteoporotic group (
p
= 0.001), while the differences in the other groups were not significant (normal
p
= 0.818/osteopenic
p
= 0.132).
Conclusions
The benefit of pedicle screw cement augmentation significantly depends on the bone mineral density and has the greatest extent of increased fatigue strength in osteoporotic vertebrae. Preoperative measurement of the BMD is strongly recommended to predict the benefit of augmentation and reinforce the decision for cement augmentation.
Graphical abstract
These slides can be retrieved under Electronic Supplementary Material.</description><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Biomechanical Phenomena - physiology</subject><subject>Bone Cements - therapeutic use</subject><subject>Bone density</subject><subject>Bone Density - physiology</subject><subject>Bone implants</subject><subject>Bone mass</subject><subject>Bone mineral density</subject><subject>Cadaver</subject><subject>Cement</subject><subject>Compression</subject><subject>Computed tomography</subject><subject>Equipment Failure Analysis - methods</subject><subject>Female</subject><subject>Humans</subject><subject>Lumbar Vertebrae - diagnostic imaging</subject><subject>Lumbar Vertebrae - physiopathology</subject><subject>Lumbar Vertebrae - surgery</subject><subject>Male</subject><subject>Materials Testing - methods</subject><subject>Mechanical properties</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Middle Aged</subject><subject>Neurosurgery</subject><subject>Original Article</subject><subject>Osteoporosis</subject><subject>Osteoporosis - diagnostic imaging</subject><subject>Osteoporosis - physiopathology</subject><subject>Pedicle Screws</subject><subject>Prosthesis Failure</subject><subject>Spine</subject><subject>Surgical Orthopedics</subject><subject>Tomography, X-Ray Computed</subject><subject>Vertebrae</subject><subject>Young Adult</subject><issn>0940-6719</issn><issn>1432-0932</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><recordid>eNp1kV9L5TAQxYMo693rfgBflsi--FKdpGnSPC0i-0cQfNHnkLbTa6RNu0mK67ffXKouLCwEBnJ-c2aYQ8gpgwsGoC4jQFXLAlhdVFJCoQ7IhomSF6BLfkg2oAUUUjF9TD7G-ATAKg3yAznmWou65HxD0r0bkaaJ2mU3ok9fz-jNONs20amnLe6_3iSb3ORpfjN2rh2QxjbgM-3d71WJKaDfpUfa4Yy-c363h5vJIx2dx2CHrPjo0ssJOertEPHTa92Sh-_f7q9_Frd3P26ur26LtlQ8FQywA9532ABrdCeshLpSwva9VJxLUXW2sY2oWwlglZZMl5LXTDQV9goFL7fkfPWdw_RrwZjM6GKLw2A9Tks0HLKjVFU-15Z8-Qd9mpbg83aZqvIwVrMyU2yl2jDFGLA3c3CjDS-GgdlHYtZITI7E7CMxKvd8fnVemhG79463DDLAVyBmye8w_B39f9c_X9OW1g</recordid><startdate>20180801</startdate><enddate>20180801</enddate><creator>Weiser, Lukas</creator><creator>Huber, Gerd</creator><creator>Sellenschloh, Kay</creator><creator>Viezens, Lennart</creator><creator>Püschel, Klaus</creator><creator>Morlock, Michael M.</creator><creator>Lehmann, Wolfgang</creator><general>Springer Berlin Heidelberg</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QP</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0001-9812-4658</orcidid></search><sort><creationdate>20180801</creationdate><title>Time to augment?! Impact of cement augmentation on pedicle screw fixation strength depending on bone mineral density</title><author>Weiser, Lukas ; Huber, Gerd ; Sellenschloh, Kay ; Viezens, Lennart ; Püschel, Klaus ; Morlock, Michael M. ; Lehmann, Wolfgang</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c372t-10ed02fdeb01b9d4a608574aff6722645dabab48c600a79619362814b5ef7e423</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2018</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Biomechanical Phenomena - physiology</topic><topic>Bone Cements - therapeutic use</topic><topic>Bone density</topic><topic>Bone Density - physiology</topic><topic>Bone implants</topic><topic>Bone mass</topic><topic>Bone mineral density</topic><topic>Cadaver</topic><topic>Cement</topic><topic>Compression</topic><topic>Computed tomography</topic><topic>Equipment Failure Analysis - methods</topic><topic>Female</topic><topic>Humans</topic><topic>Lumbar Vertebrae - diagnostic imaging</topic><topic>Lumbar Vertebrae - physiopathology</topic><topic>Lumbar Vertebrae - surgery</topic><topic>Male</topic><topic>Materials Testing - methods</topic><topic>Mechanical properties</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Middle Aged</topic><topic>Neurosurgery</topic><topic>Original Article</topic><topic>Osteoporosis</topic><topic>Osteoporosis - diagnostic imaging</topic><topic>Osteoporosis - physiopathology</topic><topic>Pedicle Screws</topic><topic>Prosthesis Failure</topic><topic>Spine</topic><topic>Surgical Orthopedics</topic><topic>Tomography, X-Ray Computed</topic><topic>Vertebrae</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Weiser, Lukas</creatorcontrib><creatorcontrib>Huber, Gerd</creatorcontrib><creatorcontrib>Sellenschloh, Kay</creatorcontrib><creatorcontrib>Viezens, Lennart</creatorcontrib><creatorcontrib>Püschel, Klaus</creatorcontrib><creatorcontrib>Morlock, Michael M.</creatorcontrib><creatorcontrib>Lehmann, Wolfgang</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Calcium & Calcified Tissue Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni)</collection><collection>ProQuest Central</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>PML(ProQuest Medical Library)</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>MEDLINE - Academic</collection><jtitle>European spine journal</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Weiser, Lukas</au><au>Huber, Gerd</au><au>Sellenschloh, Kay</au><au>Viezens, Lennart</au><au>Püschel, Klaus</au><au>Morlock, Michael M.</au><au>Lehmann, Wolfgang</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Time to augment?! Impact of cement augmentation on pedicle screw fixation strength depending on bone mineral density</atitle><jtitle>European spine journal</jtitle><stitle>Eur Spine J</stitle><addtitle>Eur Spine J</addtitle><date>2018-08-01</date><risdate>2018</risdate><volume>27</volume><issue>8</issue><spage>1964</spage><epage>1971</epage><pages>1964-1971</pages><issn>0940-6719</issn><eissn>1432-0932</eissn><abstract>Purpose
Cement augmentation of pedicle screws is known to increase their mechanical strength. Aim was to evaluate the impact of cement augmentation on pedicle screw fatigue strength in dependence of the bone mineral density (BMD).
Methods
Twenty-one human L2 vertebral bodies from donors between 19 and 96 years of age were used for in vitro experiments. BMD was measured using quantitative computed tomography (QCT). Two pedicle screws were inserted in each specimen and unilaterally augmented with bone cement. Fatigue testing was performed using a cranio-caudal sinusoidal, cyclic load (0.5 Hz) with increasing compression force (100 N + 0.1 N/cycles). Results were evaluated for the BMD groups: normal: BMD > 120 mg/cm
3
, osteopenic: BMD 80–120 mg/cm
3
, and osteoporotic: BMD < 80 mg/cm
3
bone mass.
Results
There was a significant correlation between fatigue force and BMD for the non-augmented and augmented screws (non-augmented
R
2
= 0.839,
p
< 0.001; augmented
R
2
= 0.551,
p
< 0.001). There was a significantly increased fatigue strength of the augmented screws over the non-augmented screws in the osteoporotic group (
p
= 0.001), while the differences in the other groups were not significant (normal
p
= 0.818/osteopenic
p
= 0.132).
Conclusions
The benefit of pedicle screw cement augmentation significantly depends on the bone mineral density and has the greatest extent of increased fatigue strength in osteoporotic vertebrae. Preoperative measurement of the BMD is strongly recommended to predict the benefit of augmentation and reinforce the decision for cement augmentation.
Graphical abstract
These slides can be retrieved under Electronic Supplementary Material.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>29948322</pmid><doi>10.1007/s00586-018-5660-7</doi><tpages>8</tpages><orcidid>https://orcid.org/0000-0001-9812-4658</orcidid></addata></record> |
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| ispartof | European spine journal, 2018-08, Vol.27 (8), p.1964-1971 |
| issn | 0940-6719 1432-0932 |
| language | eng |
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| source | Springer Link |
| subjects | Adult Aged Aged, 80 and over Biomechanical Phenomena - physiology Bone Cements - therapeutic use Bone density Bone Density - physiology Bone implants Bone mass Bone mineral density Cadaver Cement Compression Computed tomography Equipment Failure Analysis - methods Female Humans Lumbar Vertebrae - diagnostic imaging Lumbar Vertebrae - physiopathology Lumbar Vertebrae - surgery Male Materials Testing - methods Mechanical properties Medicine Medicine & Public Health Middle Aged Neurosurgery Original Article Osteoporosis Osteoporosis - diagnostic imaging Osteoporosis - physiopathology Pedicle Screws Prosthesis Failure Spine Surgical Orthopedics Tomography, X-Ray Computed Vertebrae Young Adult |
| title | Time to augment?! Impact of cement augmentation on pedicle screw fixation strength depending on bone mineral density |
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