Study On The Effect Of Bone Cement Screw Internal Fixation On Osteoporotic Lumbar Degeneration

Objective: To investigate the effectiveness and safety of internal fixation with bone cement screws in the treatment of lumbar degenerative diseases with osteoporosis.Methods: From May 2016 to May 2021,47 patients with lumbar degenerative disease complicated with osteoporosis were selected for posterior laminectomy and interbody bone grafting and fusion,among whom 24 patients(10 males and 14 females)were treated with conventional pedicle screw internal fixation,Another 23 patients(11 males and 12females)were treated with bone cement screw internal fixation as a control group.Disease composition: In the control group,there were 13 cases of lumbar spondylolisthesis,8cases of lumbar spinal stenosis,and 3 cases of lumbar disc herniation;In the study group,there were 10 cases of lumbar spondylolisthesis,9 cases of lumbar spinal stenosis,and 4cases of lumbar disc herniation.The operative time,intraoperative blood loss,postoperative drainage volume,preoperative,3 months,6 months,and 1-year follow-up pain VAS score,ODI index,JOA score,spinal fusion rate,screw loosening rate,screw insertion angle,and intervertebral space height were compared between the two groups.result;All patients received complete follow-up data.There was no statistically significant difference in surgical time,intraoperative bleeding,and postoperative drainage flow between the two groups,and there was no statistically significant difference in VAS scores between the two groups before surgery;The VAS scores of the study group at 3 months,6months,and 1 year after surgery were significantly higher than those of the control group at the same period(P<0.05);There was no statistically significant difference in ODI scores between the two groups during the three follow-up visits(P>0.05);The JOA scores in the study group were significantly better than those in the control group at the same period 3 and 6 months after surgery(P<0.05);There was no significant difference in JOA scores between the two groups one year after surgery(P>0.05);In the study group,there was 1 case of cerebrospinal fluid leakage,1 case of bone cement leakage and postoperative infection.During the follow-up period,there were 2 cases of screw loosening in the control group.There were no broken screws or rods.At the last follow-up,47 cases of intervertebral bone graft fusion were performed.The height loss of L3-L4 and L4-L5 intervertebral spaces in the study group was less than that in the control group,with a statistically significant difference.Conclusion;Posterior laminectomy and intervertebral bone graft fusion can effectively relieve nerve compression.Combined with the use of bone cement reinforced pedicle screws,it significantly improves the grip of the screws on the osteoporotic vertebral body,increases the reliability and safety of fixation,reduction,and stability,significantly reduces the loss of intervertebral space height,and ensures long-term maintenance of surgical results.However,its corresponding complications should also be paid attention to.