Augmented Cervical Stabilisation for Failed Fixation in Patients with Severe Osteoporosis – Two Case Reports

Česká verzia

Authors: P. Barsa; R. Fröhlich; P. Suchomel
Authors place of work: Neurochirurgické oddělení, Neurocentrum, Krajská nemocnice Liberec, a. s.
Published in the journal: Cesk Slov Neurol N 2013; 76/109(4): 486-491
Category: Case Report

Summary

The instrumented spinal fusion in patients with osteoporosis is challenging because of poor bone quality and difficult due to frequent instrument failure secondary to pullout of screws and intervertebral body fusion device subsidence, leading to revision procedures. The authors treated two severely osteoporotic patients presenting with hardware failure after an index procedure in cervical spine. Combined antero‑posterior stabilisation at multiple levels in conjunction with vertebroplasty of instrumented cervical vertebral bodies enabled reduced postoperative deformity and led to long‑term stability of the construct. Clinical experience obtained with these two patients support theoretical assumption that additional vertebroplasty not just strengthens osteoporotic vertebral bodies but also immediately anchors the screws and reduces a risk of intervertebral body device subsidence. Therefore, this seems to be a viable strategy for treatment of osteoporotic patients after cervical spine hardware failure.

Key words:
device failure – osteoporosis – internal fixation – polymethylmethacrylate vertebroplasty – cervical spine

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