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2022, Vol. 26 ›› Issue (3): 403-407

Cortical bone trajectory in elderly patients with osteoporosis of lumbar disease

Cai Feng, Yu Bo, Zeng Duo, Chen Qincan, Liao Qi   

  1. Third Affiliated Hospital of Nanchang University, Nanchang 330000, Jiangxi Province, China

  • Received:2021-01-25 Revised:2021-01-27 Accepted:2021-03-04 Online:2022-01-28 Published:2021-10-27

  • Contact: Chen Qincan, Master candidate, Third Affiliated Hospital of Nanchang University, Nanchang 330000, Jiangxi Province, China Liao Qi, Master, Professor, Master’s supervisor, Third Affiliated Hospital of Nanchang University, Nanchang 330000, Jiangxi Province, China

  • About author:Cai Feng, Master, Attending physician, Third Affiliated Hospital of Nanchang University, Nanchang 330000, Jiangxi Province, China

  • Supported by:

    the Science and Technology Plan of Jiangxi Health Commission, No. 20202007 (to CF)



Abstract: BACKGROUND: In patients with lumbar spine disease combined with osteoporosis, the loss of bone mass and the destruction of trabecular bone structure reduce the holding power of traditional pedicle screws, which can easily cause complications, such as screw loosening, fracture, and loss of vertebral body height. It is one of the common reasons for the failure of lumbar spine surgery.  
OBJECTIVE: To explore the effect of cortical bone trajectory in osteoporosis of lumbar disease.
METHODS:   From January 2019 to February 2020, 60 patients with osteoporosis of lumbar disease in the Third Affiliated Hospital of Nanchang University were randomly divided into two groups. The control group received the fixation with traditional pedicle screw. The observation group received the fixation with cortical bone screws. Both groups were treated with posterior lumbar fusion. Operation time, intraoperative blood loss, postoperative drainage volume, vertebral fusion rate after operation, and any related complications were recorded in the two groups. Japanese Orthopaedic Association scores were compared preoperatively and 3 and 6 months postoperatively.  

RESULTS AND CONCLUSION: (1) There was no statistically significant difference in the fusion rate between the two groups (P > 0.05). (2) Operation time, intraoperative blood loss, and postoperative drainage volume were better in the observation group than those in the control group (P < 0.05). (3) After surgery, in the control group, complications occurred in six patients, including failure of internal fixation in two cases, infection in two cases and cerebrospinal fluid leakage in two cases. There was no complication in the observation group. (4) Japanese Orthopaedic Association scores were better in the observation group than those in the control group at 3 and 6 months postoperatively (P < 0.05). (5) It is indicated that compared with traditional pedicle screw fixation, cortical bone trajectory can not only significantly improve the symptoms of lumbar disease, but also reduce operation time, intraoperative blood loss and postoperative drainage volume, and reduce intraoperative complications.

Key words:traditional pedicle screw, cortical bone trajectory, osteoporosis, lumbar spine, internal fixation


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