J Korean Soc Spine Surg.  2008 Dec;15(4):243-249. 10.4184/jkss.2008.15.4.243.

Metal Failure in patients with Short-segmental Pedicle Screw Fixation and Fusion for Degenerative Lumbar Disease: Comparison Monoaxial with Polyaxial Screw

• Kim WJ
• Kang JW
• Sung HI
• Park KY
• Park JG
• Kim YI
• Choy WS

• KMID: 2209627
• DOI: http://doi.org/10.4184/jkss.2008.15.4.243

Abstract

STUDY DESIGN: Retrospective study
OBJECTIVE
To evaluate the factors affecting metal failure and screw loosening of short-segmental (1- or 2-segmental) monoaxial or polyaxial screw fixation for degenerative lumbar disease. SUMMARY OF LITERATURE REVIEW: There was a report on metal failure and screw loosening in short-segmental monoaxial and polyaxial screw fixation in degenerative lumbar disease.
MATERIALS AND METHODS
This study examined 227 cases who underwent short-segmental transpedicular screw fixation and vertebral fusion for a degenerative lumbar.
RESULTS
Metal failure of transpedicular screws was detected in 6 cases, 3 each in groups A and B. Screw loosening occurred in 16 and 43 cases in group A and B, respectively. Both groups had a similar incidence of spinal stenosis with instability and spondylolisthesis. The failure rate and screw loosening according to the fusion level was also similar. The failure and screw loosening rates was higher in the cases who did not undergo PLIF than in the cases who underwent PLIF but the difference was not statistically significant.
CONCLUSION
The metal failure and screw loosening rates after transpedicular screw fixation and spinal fusion procedures for degenerative lumbar diseases using monoaxial screws and polyaxial screws were similar.

Keyword

Degenerative lumbar diseases; Short-segmental transpedicular screw fixation; Metal failure; Monoaxial and Polyaxial screw

MeSH Terms

Humans
Incidence
Retrospective Studies
Spinal Fusion
Spinal Stenosis
Spondylolisthesis

Figure

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  Fig. 1. 59-year-old patient with spinal stenosis of the lumbar spine. A continuous lucency at the screw-bone interface surrounded by a thin radiolucent zone (halo sign-black arrows) on the AP radiograph indicates loosening of both distal screws on 4 months follow up.

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  Fig. 2. 62-year-old patient with spinal stenosis shows pull-out (black arrow) of screws from the vertebral body due to increase of kyphosis of the lumbar spine on 4 months (A) and 10 months (B) follow up.

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  Fig. 3. 67-year-old patient with spinal stenosis shows screw-rod dissociation on 2 months follow up.

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