Computed Tomography-Based Prediction of Lumbar Pedicle Screw Loosening

• Published in: BioMed research international 2023, Vol.2023 (1), p.8084597-8084597
• Main Authors: Shu, Li, Wang, Xiaoyuan, Li, Lei, Aili, Abudunaibi, Zhang, Rui, Liu, Wenge, Muheremu, Aikeremujiang
• Format: Article
• Language: English
• Subjects: Aged; Back surgery; Body mass index; Bone density; Bone implants; Care and treatment; Child, Preschool; Complications; Computed tomography; CT imaging; Diabetes; Diabetes mellitus; Embolisms; Female; Hospitals; Humans; Infant; Loosening; Low back disorders; Lumbar Vertebrae - diagnostic imaging; Lumbar Vertebrae - surgery; Male; Medical imaging; Osteoporosis; Patients; Pedicle screws; Pedicle Screws - adverse effects; Predictions; Prospective Studies; Retrospective Studies; Risk analysis; Risk factors; Scoliosis; Sensitivity; Spinal diseases; Spinal Fusion - methods; Spinal stenosis; Spondylolisthesis; Spondylolisthesis - diagnostic imaging; Spondylolisthesis - surgery; Surgery; Tomography; Tomography, X-Ray Computed; Variance analysis; Vertebrae
• ISSN: 2314-6133; 2314-6141
• DOI: 10.1155/2023/8084597

Objective. Pedicle screw loosening is one of the main complications after pedicle screw fixation. However, there are few reliable measures for prediction of screw loosening. The current study was carried out to find an effective method to use preoperative CT scanning as a predictor of screw loosening in the elderly patients and provide guidance for preoperative surgical planning. Methods. Patients who were treated with lumbar pedicle screw fixation procedure in our department for degenerative lumbar disorders between January 2015 and January 2021 were retrospectively included in the current study. CT scan attenuation of each vertebra was measured with Hounsfield units (HU). Screw loosening was determined in postoperatively X-ray tests. One-way analysis of variance (ANOVA) and receiver operating characteristic (ROC) curve analysis were carried out with IBMSPSS 24.00 software. Results. Screw loosening was observed in 44 of 215 patients (124 male, 91 female, average age 58.4±7.6 years) during a mean follow-up time of 19.0±11.2 months (range 12-32 months). No significant differences were found among the patients concerning patient gender, BMI, habit of smoking, and whether or not the patient had diabetes or suffered from spondylolisthesis (P>0.05). The average HU value of lumbar vertebra was 122.4±32.8 HU in the screw loosening group and 142.4±38.2 HU in the control group, and the difference was significant (P