Skip to main content
SpringerLink
Log in

Percutaneous consolidation of loosened spine arthrodesis under CT and fluoroscopy guidance by radiologists: a new useful technique

  • Vascular-Interventional
  • Published:
European Radiology Aims and scope Submit manuscript

Abstract

Objective

The objective was to evaluate percutaneous computed tomography (CT) and fluoroscopy-guided injection of bone cement for consolidation of loosened posterior arthrodesis performed by radiologists.

Methods

A single-centre prospective study involving four consecutive patients (three women, one man) suffering from screw loosening (three at the vertebral level, one at the iliac wing level) after Posterior Lumbar Interbody Fusion (PLIF) treatment was done. The average age was 80 years. Surgical treatment was not indicated or not wished for by the patients. Institutional review board approval and informed consent were obtained. Percutaneous consolidation was performed by an interventional radiologist under CT and fluoroscopy guidance. The path of the trocars was made outside loosened screws bilaterally. Follow-up was assessed using the Visual Analog Scale (VAS).

Results

In all cases, bone cement was successfully placed around the loosened screw. The mean volume of cement that was injected was 3 ml. No cement leakage was observed. No neurological complication occurred. Using VAS, pain decreased from more than 9/10 preoperatively to less than 2/10 the day after the procedure for all patients (p < 0.05).

Conclusion

This study suggests that loosening of spine arthrodesis could be successfully treated by percutaneous injection of bone cement under CT and fluoroscopy guidance.

Key Points

• PLIF is one of the surgical techniques for spinal arthrodesis.

• Treatment indications are degenerative disease or instability following trauma, tumour, or infection.

• Screw loosening is a frequent complication that can occur after surgery.

• Percutaneous facet consolidation under dual guidance seems to be a feasible technique.

• The procedure is performed under local anaesthesia using a minimally invasive approach.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5

Similar content being viewed by others

Abbreviations

PLIF:

posterior lumbar interbody fusion

VAS:

visual analogue scale

CT:

computed tomography

References

  1. Mummanemi PV, Haid RW, Rodts GE (2004) Lumbar interbody fusion: state-of-the-art, technical advances Invited submission from the joint section meeting on disorders of the spine and peripheral nerves. March 2004. J Neurosurg Spine 1:24–30

    Article  Google Scholar 

  2. Starkweather A (2006) Posterior lumbar interbody fusion: an old concept with new techniques. J Neurosci Nurs 38:13–20

    Article  PubMed  Google Scholar 

  3. Vaziri K, Brody F, Yu W (2006) Surgical treatment of Pott’s disease. J Am Coll Surg 203:252

    Article  PubMed  Google Scholar 

  4. Cole CD, McCall TD, Schmidt MH, Dailey AT (2009) Comparison of low back fusion techniques: transforaminal lumbar interbody fusion (TLIF) or posterior lumbar interbody fusion (PLIF) approaches. Curr Rev Musculoskeletal Med 2(2):118–126

    Article  Google Scholar 

  5. Young PM, Berquist TH, Bancroft LW, Peterson JJ (2007) Complications of spinal instrumentation. Radiographics 27:775–789

    Article  PubMed  Google Scholar 

  6. Okuyama K, Abe E, Suzuki T (2001) Influence of bone mineral density on pedicle screw fixation: a study of pediclescrew fixation augmenting posterior lumbar interbody fusion in elderly patients. Spine J 1(6):402–407

    Article  CAS  PubMed  Google Scholar 

  7. Puri AS, Erdem E (2010) Salvage percutaneous vertebral augmentation in failed spinal interbody fusions associated with multiple myeloma. Spine J 10(8):e5–e10

    Article  PubMed  Google Scholar 

  8. Moon E, Tam M, Kikano R, Karuppasamy K (2010) Prophylactic antibiotic guidelines in modern interventional radiology practice; Semin Intervent. Radiology 27:327–337

    Google Scholar 

  9. Liu D, Wu Z, Fu S, Gao M (2011) Biomechanical comparison of different techniques in primary spinal surgery in osteoporotic lumbar vertebrae: expansive pedicle screw versus PMMA-augmented pedicle screw. Orth and Trauma Surgery 131(9):1227–1232

    Article  Google Scholar 

  10. Law M, Tencer AF, Anderson PA (1993) Caudo-Cephalad loading of pedicle screw : mechanism of loosening and methods of augmentation. Spine

  11. Turner A, Gillies RM, Svehla MJ, Saito M, Walsh WR (2003) Hydroxyapatite composite resin cement augmentation of pedicle screw fixation. Curr Orth Practice 406(1):253–261

    Google Scholar 

Download references

Acknowledgements

The scientific guarantor of this publication is Pauline Foti. The authors of this manuscript declare no relationships with any companies, whose products or services may be related to the subject matter of the article. The authors state that this work has not received any funding. No complex statistical methods were necessary for this paper. Institutional Review Board approval was obtained. Written informed consent was obtained from all subjects (patients) in this study. Methodology: prospective, observational, performed at one institution.

Author information

Authors and Affiliations

  1. Centre Hospitalier Universitaire de Nice, Nice, France

    Nicolas Amoretti, Anne-Sophie Bertrand, Giacomo Gallo, Amandine Caudal & Pascal Boileau

  2. Centre Hospitalier Universitaire de Bordeaux, Bordeaux, France

    Francois Cornelis & Olivier Hauger

Authors
  1. Nicolas Amoretti
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Anne-Sophie Bertrand
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Giacomo Gallo
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Amandine Caudal
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Francois Cornelis
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Olivier Hauger
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Pascal Boileau
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Nicolas Amoretti.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Amoretti, N., Bertrand, AS., Gallo, G. et al. Percutaneous consolidation of loosened spine arthrodesis under CT and fluoroscopy guidance by radiologists: a new useful technique. Eur Radiol 25, 1135–1139 (2015). https://doi.org/10.1007/s00330-014-3475-4

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00330-014-3475-4

Keywords

Search

Navigation