Clinical Curative Effect of the Combined Use of Cortical Bone Trajectory Screws and Pedicle Screws for Internal Fixation in the Treatment of Senile Osteoporosis and Lumbar Degenerative Diseases

Objective: This study aims to explore the clinical curative effect of internal fixation and bone graft using cortical bone trajectory screws (CBT) combined with pedicle screws (PS) to decompress the lumbar posterior during the treatment of osteoporosis and lumbar degenerative diseases. Method: From February 2014 to August 2015, the researcher chose 40 patients with osteoporosis and lumbar degenerative diseases, for whom former conservative treatment proved invalid, and operated internal fixation and bone graft to decompress the lumbar posterior. Pedicle screw fixation was performed on 27 cases in Group A, while the technique of cortical bone screws combined with pedicle screws was adopted for 13 cases in Group B. The two groups of patients were observed with respect to the operative duration, intraoperative blood loss, and VAS scores before and after the surgery, JOA score, and improvement rate. Results: The symptoms of all the 40 patients were improved. Postoperative JOA and VAS scores significantly increased. In regard of operative duration, blood loss, JOA and VAS scores of the two groups, there was no difference of statistical significance. Bilateral pedicle screw placement failed for two cases in Group A and unilateral fixation was used instead. The rest of the patients succeeded with the screw placement. As to Group B patients, there was not a single case of placement failure due to the inadequate adhesive force, or any fracture of the cortical bone screw trajectory. The placement process inflicted no vascular or nervous damage upon any of the patients. Postoperative radiographic follow-up showed no screw loosening, fall-off, or collapse. The screws, connecting rods, fusion devices were well located at good positions. No adverse events happened to any patient. Conclusion: There are several advantages of jointly using cortical bone trajectory screws and pedicle screws for internal fixation in the treatment of senile osteoporosis and lumbar degenerative diseases: small injuries in the muscles and soft tissues, strong adhesive force, and satisfactory early effects.

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