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Research ArticleSpine Imaging and Spine Image–guided Interventions

An Extended Follow-up of Spinal Instrumentation Rescue with Cement Augmentation

F. Polinelli, M. Pileggi, I. Cabrilo, C. Commodaro, S.M.J. van Kuijk, A. Cardia and A. Cianfoni
American Journal of Neuroradiology November 2024, 45 (11) 1805-1810; DOI: https://doi.org/10.3174/ajnr.A8394
F. Polinelli
aFrom the Department of Neurosurgery (F.P., I.C., A. Cardina), Neurocenter of Southern Switzerland, Ente Ospedaliero Cantonale, Lugano, Switzerland
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M. Pileggi
bDepartment of Neuroradiology (M.P. C.C., A. Cianfoni), Neurocenter of Southern Switzerland, Ente Ospedaliero Cantonale, Lugano, Switzerland
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I. Cabrilo
aFrom the Department of Neurosurgery (F.P., I.C., A. Cardina), Neurocenter of Southern Switzerland, Ente Ospedaliero Cantonale, Lugano, Switzerland
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C. Commodaro
bDepartment of Neuroradiology (M.P. C.C., A. Cianfoni), Neurocenter of Southern Switzerland, Ente Ospedaliero Cantonale, Lugano, Switzerland
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S.M.J. van Kuijk
cDepartment of Clinical Epidemiology and Medical Technology Assessment (S.M.J.v.K., A. Cianfoni), Maastricht University Medical Center, Maastricht, the Netherlands
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A. Cardia
aFrom the Department of Neurosurgery (F.P., I.C., A. Cardina), Neurocenter of Southern Switzerland, Ente Ospedaliero Cantonale, Lugano, Switzerland
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A. Cianfoni
bDepartment of Neuroradiology (M.P. C.C., A. Cianfoni), Neurocenter of Southern Switzerland, Ente Ospedaliero Cantonale, Lugano, Switzerland
cDepartment of Clinical Epidemiology and Medical Technology Assessment (S.M.J.v.K., A. Cianfoni), Maastricht University Medical Center, Maastricht, the Netherlands
dDepartment of Neuroradiology (A. Cianfoni), Inselspital, University of Bern, Bern, Switzerland
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Abstract

BACKGROUND AND PURPOSE: Percutaneous cement augmentation has been reported as an effective salvage procedure for frail patients with spinal instrumentation failure, such as screw loosening, hardware breakage, cage subsidence, and fractures within or adjacent to stabilized segments. Favorable results were reported during a median follow-up period of 16 months in a retrospective analysis of 31 consecutive procedures performed in 29 patients. In the present study, the long-term effectiveness of this treatment in avoiding or postponing revision surgery is reported.

MATERIALS AND METHODS: Clinical and radiologic data of our original cohort of patients were retrospectively collected and reviewed to provide an extended follow-up assessment. The need for revision spinal surgery was assessed as the primary outcome, and the radiologic stability of the augmented spinal implants was considered as the secondary outcome.

RESULTS: An extended radiologic follow-up was available in 27/29 patients with an average of 50.9 months. Overall, 18 of 27 (66.7%) patients, originally candidates for revision surgery, avoided a surgical intervention after a cement augmentation rescue procedure. In the remaining patients, the average interval between the rescue cement augmentation and the revision surgery was 22.5 months. Implant mobilization occurred in 2/27 (7.4%) patients; rod breakage, in 1/27 (3.7%); a new fracture within or adjacent to the instrumented segment occurred in 4/27 (14.8%) patients; and screw loosening at rescued levels occurred in 5/27 (18.5%) patients.

CONCLUSIONS: In this cohort, cement augmentation rescue procedures were found to be effective in avoiding or postponing revision surgery during long-term follow-up.

ABBREVIATION:

ASA
American Society of Anesthesiologists
  • © 2024 by American Journal of Neuroradiology
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American Journal of Neuroradiology: 45 (11)
American Journal of Neuroradiology
Vol. 45, Issue 11
1 Nov 2024
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Cite this article
F. Polinelli, M. Pileggi, I. Cabrilo, C. Commodaro, S.M.J. van Kuijk, A. Cardia, A. Cianfoni
An Extended Follow-up of Spinal Instrumentation Rescue with Cement Augmentation
American Journal of Neuroradiology Nov 2024, 45 (11) 1805-1810; DOI: 10.3174/ajnr.A8394

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Follow-up on Spinal Instrumentation Rescue
F. Polinelli, M. Pileggi, I. Cabrilo, C. Commodaro, S.M.J. van Kuijk, A. Cardia, A. Cianfoni
American Journal of Neuroradiology Nov 2024, 45 (11) 1805-1810; DOI: 10.3174/ajnr.A8394
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