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Open Access 01-12-2021 | Computed Tomography | Research article

Comparative analysis of clinical factors associated with pedicle screw pull‐out during or immediately after surgery between intraoperative cone‐beam computed tomography and postoperative computed tomography

Authors: Satoshi Sumiya, Kazuyuki Fukushima, Yoshiro Kurosa, Takashi Hirai, Hiroyuki Inose, Toshitaka Yoshii, Atsushi Okawa

Published in: BMC Musculoskeletal Disorders | Issue 1/2021

Abstract

Background

No studies to date have elucidated the clinical factors associated with pedicle screw pull-out during or immediately after surgery. The aim of this study was to assess the frequency of pedicle screw pull-out by comparing intraoperative scans obtained using cone-beam computed tomography (CBCT) with postoperative scans obtained using computed tomography (CT). We also sought to determine the incidence of pedicle screw pull-out and identify relevant risk factors.

Methods

This was a retrospective analysis of prospectively collected data for 742 pedicle screws placed in 76 consecutive patients who underwent at least triple-level posterior fixation for thoracic or lumbar spinal injury, spinal metastasis, or pyogenic spondylitis between April 2014 and July 2020. Pedicle screw pull-out distance in the axial and sagittal planes was compared between CT scans obtained 2 days postoperatively and CBCT images acquired intraoperatively. Risk factors associated with pedicle screw pull-out were investigated by multivariate logistic regression analysis.

Results

Pedicle screw pull-out was seen with 58 pedicle screws (7.8%) in 26 patients (34.2%). There were significant differences in age, number of fused segments, frequency of diffuse idiopathic skeletal hyperostosis (DISH), and medical history of osteoporosis for pedicle screw pull-out. Risk factors for pedicle screw pull-out were older age (odds ratio 1.07, 95% confidence interval 1.02–1.130) and a diagnosis of DISH (odds ratio 3.35, 95% confidence interval 1.12–10.00). Several cases suggest that use of connecting rods was an important factor in intraoperative pedicle screw pull-out.

Conclusions

Our findings suggest that age, number of fused segments, presence of DISH, and medical history of osteoporosis are risk factors for pedicle screw pull-out, with the greatest being older age and DISH.

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Title: Comparative analysis of clinical factors associated with pedicle screw pull‐out during or immediately after surgery between intraoperative cone‐beam computed tomography and postoperative computed tomography
Authors: Satoshi Sumiya
Kazuyuki Fukushima
Yoshiro Kurosa
Takashi Hirai
Hiroyuki Inose
Toshitaka Yoshii
Atsushi Okawa
Publication date: 01-12-2021
Publisher: BioMed Central
Keywords: Computed Tomography
Computed Tomography
Osteoporosis
Osteoporosis
Published in: BMC Musculoskeletal Disorders / Issue 1/2021
Electronic ISSN: 1471-2474
DOI: https://doi.org/10.1186/s12891-020-03916-9

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Comparative analysis of clinical factors associated with pedicle screw pull‐out during or immediately after surgery between intraoperative cone‐beam computed tomography and postoperative computed tomography

Abstract

Background

Methods

Results

Conclusions

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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