PERCUTANEOUS SACROPLASTY FOR THE TREATMENT OF SACRAL PEDICLE SCREW LOOSENING IN AN OSTEOPOROTIC PATIENT
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PERCUTANEOUS SACROPLASTY FOR THE TREATMENT OF SACRAL PEDICLE SCREW LOOSENING IN AN OSTEOPOROTIC PATIENT

J Turk Spinal Surg 2017;28(3):187-190
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Abstract

Pedicle screw loosening is a major concern especially in the osteoporotic spine. It results from the loss of metal-bone interface integrity. Once a screw pullout occurs, the surgeon should revise the implant. Different salvage techniques exist such as using larger screws, screws with a larger thread depth and pitch, expandable screws, screws with bicortical purchase, milled bone graft impacted into the pilot hole, or PMMA augmented screws. We describe a new, minimally invasive salvage technique that could be an alternative to open revision surgeries. As an alternative to open, major revision surgeries for failed and/or loosened instrumentation systems, we suggest minimally invasive cement augmentation procedure under local anesthesia.

Keywords: pedicle screw, sacrum, augmentation, vertebroplasty, polymethlymethacrylate