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Abstract
Background This prospective study was designed to evaluate the middle-to long-term purchase of cement-augmented fenestrated pedicular screws in patients with poor bone quality due to osteoporosis,infection and/or tumours. The growing number of surgical procedures performed in the spine has highlighted the problem of screws loosening in these patients. Patients and methods from May 2015 to January 2016, 25 patients with a poor bone stock condition underwent posterior stabilisation by fenestrated pedicle screws and PMMA augmentation. Pain improvement and long-term clinical outcome were assessed by visual analogue scale (VAS) score and Oswestry low back disability questionnaire ( Oswestry disability index ODI). Implant stability was evaluated by plain radiography. Complications were evaluated in all cases. Results All patients were clinically and radiographically followed up for a mean of 12.84 months. VAS scores and ODI questionnaire showed a statistically significant reduction in pain and improvement in the quality of life. No radiological loosening or pulling out of screws was observed. In two cases, cement leakage occurred intraoperatively. Conclusion Fenestrated screws and cement augmentation provided effective and lasting purchase in patients with poor bone quality. The only clinical complication strictly related to PMMA screw augmentation did not require further surgery