Universität zu Köln

Bredow, Jan, Boese, C. K., Werner, C. M. L., Siewe, J., Loehrer, L., Zarghooni, K., Eysel, P. and Scheyerer, M. J. (2016). Predictive validity of preoperative CT scans and the risk of pedicle screw loosening in spinal surgery. Arch. Orthop. Trauma Surg., 136 (8). S. 1063 - 1068. NEW YORK: SPRINGER. ISSN 1434-3916

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Abstract

Pedicle screw fixation is the standard technique for the stabilization of the spine, a clinically relevant complication of which is screw loosening. This retrospective study investigates whether preoperative CT scanning can offer a predictor of screw loosening. CT-scan attenuation in 365 patients was evaluated to determine the mean bone density of each vertebral body. Screw loosening or dislocation was determined in CT scans postoperatively using the standard radiological criteria. Forty-five of 365 patients (12.3 %; 24 male, 21 female) suffered postoperative screw loosening (62 of 2038 screws) over a mean follow-up time of 50.8 months. Revision surgeries were necessary in 23 patients (6.3 %). The correlation between decreasing mean CT attenuation in Hounsfield Units (HU) and increasing patient age was significant (p < 0.001). Mean bone density was 116.3 (SD 53.5) HU in cases with screw loosening and 132.7 (SD 41.3) HU in cases in which screws remained fixed. The difference was statistically significant (p = 0.003). The determination of bone density with preoperative CT scanning can predict the risk of screw loosening and inform the decision to use cement augmentation to reduce the incidence of screw loosening.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Bredow, Jan UNSPECIFIED UNSPECIFIED UNSPECIFIED Boese, C. K. UNSPECIFIED UNSPECIFIED UNSPECIFIED Werner, C. M. L. UNSPECIFIED UNSPECIFIED UNSPECIFIED Siewe, J. UNSPECIFIED UNSPECIFIED UNSPECIFIED Loehrer, L. UNSPECIFIED UNSPECIFIED UNSPECIFIED Zarghooni, K. UNSPECIFIED UNSPECIFIED UNSPECIFIED Eysel, P. UNSPECIFIED UNSPECIFIED UNSPECIFIED Scheyerer, M. J. UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-268425
DOI:	10.1007/s00402-016-2487-8
Journal or Publication Title:	Arch. Orthop. Trauma Surg.
Volume:	136
Number:	8
Page Range:	S. 1063 - 1068
Date:	2016
Publisher:	SPRINGER
Place of Publication:	NEW YORK
ISSN:	1434-3916
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language BONE-MINERAL DENSITY; LUMBAR SPINE; DYNAMIC STABILIZATION; HOUNSFIELD UNITS; DIAGNOSTIC CT; FIXATION; FUSION Multiple languages Orthopedics; Surgery Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/26842