Osteoporosis can either cause thoracolumbar fractures (nontraumatic fracture) or may function as a contributing factor in cases of traumatic fractures. This study confirms that the application of polymethyl methacrylate augmented Cement-Injectable Cannulated Pedicle Screw (CICPS) as an effective and safe surgical method for the management of osteoporosis-related vertebral fractures with good clinical outcomes and low complications rates.

Assessment of the safety and efficacy of novel polymethyl methacrylate-augmented bone cement-injectable cannulated pedicle screw (CICPS) in patients with AO type A-thoracolumbar vertebral compression fractures associated with osteoporosis.

A retrospective cohort study was conducted on 28 patients treated for osteoporosis-related thoracolumbar vertebral body compression fracture between 2011-2015. Treatment involved posterior thoracolumbar fusion or lumbar fusion using CICPS technique. Treatment effectiveness was evaluated using the Oswestry Disability Index scores and visual analog scale (VAS), the degree of fracture reduction, and correction of kyphosis. The safety of CICPS was mainly assessed for intraoperative and postoperative complications. CT-scan, radiography and MRI imaging outcomes were also evaluated.

All 28 patients were having severe osteoporosis. The VAS at final follow-up (0.50 ± 0.69) was significantly lower as compared to before surgery (4.93 ± 1.30). There was a significant decrease in the Oswestry Disability Index score at final follow-up, i.e., from 57.39% ± 14.46% to 6.83% ± 15.38%. It was also observed that at the final follow-up the Radiologic evaluation of vertebral height and Cobb angle showed measurable fracture reduction and satisfactory correction of kyphosis. No occurrence of screw loosening or symptomatic complications were seen, only a few cases presented cement leakage (10.3%; cement leakage most common in AO type A3.3) from CICPS.

Polymethyl methacrylate augmented CICPS found to be a safe and effective surgical technique for management of osteoporosis-related vertebral fractures (AO type A). This method also exhibited good clinical outcomes and low complications rates.