Correlation of bone density to screw loosening in dynamic stabilization: an analysis of 176 patients

Abstract Although osteoporosis has negative impacts on lumbar fusion, its effects on screw loosening in dynamic stabilization remain elusive. We aimed to correlate bone mineral density (BMD) with screw loosening in Dynesys dynamic stabilization (DDS). Consecutive patients who underwent 2- or 3-level...

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Autores principales:	Hsuan-Kan Chang, Jason Ku, Johnson Ku, Yi-Hsuan Kuo, Chih-Chang Chang, Ching-Lan Wu, Jiing-Feng Lirng, Jau-Ching Wu, Wen-Cheng Huang, Henrich Cheng, Shih-Ming Hsu
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/3df406ab40fa406eb60416f894db5d2b
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spelling	oai:doaj.org-article:3df406ab40fa406eb60416f894db5d2b2021-12-02T15:28:52ZCorrelation of bone density to screw loosening in dynamic stabilization: an analysis of 176 patients10.1038/s41598-021-95232-y2045-2322https://doaj.org/article/3df406ab40fa406eb60416f894db5d2b2021-09-01T00:00:00Zhttps://doi.org/10.1038/s41598-021-95232-yhttps://doaj.org/toc/2045-2322Abstract Although osteoporosis has negative impacts on lumbar fusion, its effects on screw loosening in dynamic stabilization remain elusive. We aimed to correlate bone mineral density (BMD) with screw loosening in Dynesys dynamic stabilization (DDS). Consecutive patients who underwent 2- or 3-level DDS for spondylosis, recurrent disc herniations, or low-grade spondylolisthesis at L3-5 were retrospectively reviewed. BMD was assessed by the Hounsfield Unit (HU) in vertebral bodies (VB) and pedicles with and without cortical bone (CB) on pre-operative computed tomography (CT). Screw loosening was assessed by radiographs and confirmed by CT. HU values were compared between the loosened and intact screws. 176 patients and 918 screws were analyzed with 78 loosened screws found in 36 patients (mean follow-up: 43.4 months). The HU values of VB were similar in loosened and intact screws (p = 0.14). The HU values of pedicles were insignificantly less in loosened than intact screws (including CB: 286.70 ± 118.97 vs. 297.31 ± 110.99, p = 0.45; excluding CB: 238.48 ± 114.90 vs. 240.51 ± 108.91, p = 0.88). All patients had clinical improvements. In conclusion, the HU values, as a surrogate for BMD, were unrelated to screw loosening in DDS. Therefore, patients with compromised BMD might be potential candidates for dynamic stabilization rather than fusion.Hsuan-Kan ChangJason KuJohnson KuYi-Hsuan KuoChih-Chang ChangChing-Lan WuJiing-Feng LirngJau-Ching WuWen-Cheng HuangHenrich ChengShih-Ming HsuNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 11, Iss 1, Pp 1-7 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Hsuan-Kan Chang Jason Ku Johnson Ku Yi-Hsuan Kuo Chih-Chang Chang Ching-Lan Wu Jiing-Feng Lirng Jau-Ching Wu Wen-Cheng Huang Henrich Cheng Shih-Ming Hsu Correlation of bone density to screw loosening in dynamic stabilization: an analysis of 176 patients
description	Abstract Although osteoporosis has negative impacts on lumbar fusion, its effects on screw loosening in dynamic stabilization remain elusive. We aimed to correlate bone mineral density (BMD) with screw loosening in Dynesys dynamic stabilization (DDS). Consecutive patients who underwent 2- or 3-level DDS for spondylosis, recurrent disc herniations, or low-grade spondylolisthesis at L3-5 were retrospectively reviewed. BMD was assessed by the Hounsfield Unit (HU) in vertebral bodies (VB) and pedicles with and without cortical bone (CB) on pre-operative computed tomography (CT). Screw loosening was assessed by radiographs and confirmed by CT. HU values were compared between the loosened and intact screws. 176 patients and 918 screws were analyzed with 78 loosened screws found in 36 patients (mean follow-up: 43.4 months). The HU values of VB were similar in loosened and intact screws (p = 0.14). The HU values of pedicles were insignificantly less in loosened than intact screws (including CB: 286.70 ± 118.97 vs. 297.31 ± 110.99, p = 0.45; excluding CB: 238.48 ± 114.90 vs. 240.51 ± 108.91, p = 0.88). All patients had clinical improvements. In conclusion, the HU values, as a surrogate for BMD, were unrelated to screw loosening in DDS. Therefore, patients with compromised BMD might be potential candidates for dynamic stabilization rather than fusion.
format	article
author	Hsuan-Kan Chang Jason Ku Johnson Ku Yi-Hsuan Kuo Chih-Chang Chang Ching-Lan Wu Jiing-Feng Lirng Jau-Ching Wu Wen-Cheng Huang Henrich Cheng Shih-Ming Hsu
author_facet	Hsuan-Kan Chang Jason Ku Johnson Ku Yi-Hsuan Kuo Chih-Chang Chang Ching-Lan Wu Jiing-Feng Lirng Jau-Ching Wu Wen-Cheng Huang Henrich Cheng Shih-Ming Hsu
author_sort	Hsuan-Kan Chang
title	Correlation of bone density to screw loosening in dynamic stabilization: an analysis of 176 patients
title_short	Correlation of bone density to screw loosening in dynamic stabilization: an analysis of 176 patients
title_full	Correlation of bone density to screw loosening in dynamic stabilization: an analysis of 176 patients
title_fullStr	Correlation of bone density to screw loosening in dynamic stabilization: an analysis of 176 patients
title_full_unstemmed	Correlation of bone density to screw loosening in dynamic stabilization: an analysis of 176 patients
title_sort	correlation of bone density to screw loosening in dynamic stabilization: an analysis of 176 patients
publisher	Nature Portfolio
publishDate	2021
url	https://doaj.org/article/3df406ab40fa406eb60416f894db5d2b
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Correlation of bone density to screw loosening in dynamic stabilization: an analysis of 176 patients

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