Abstract:
Objective: To assess safety and efficacy of sublaminar mersilene tape
augmented pedicle screws fixation as a novel and low cost modality of
spinal instrumentation for osteoporotic vertebral compression fractures
treatment.
Methods: A retrospective study of 40 consecutive patients of the
osteoporotic vertebral compression fractures. All patients were operated
with open surgery with decompression, pedicle screw fixation, and
sublaminar mersilene tape augmentation. Clinical, functional, and
radiological outcomes were compared to describe the utility of
sublaminar mersilene tape augmented pedicle screws for the treatment
of osteoporotic vertebral compression fractures.
Results: Compete neurological improvement was noted in 38 patients
(Frankel Grade-D to Grade-E), two patients remain with Frankel Garde
D neurology. Significant improvement was noted in VAS (preoperative
7.90±0.60 to final follow-up 2.90±0.54) and ODI (preoperative 77.10
±6.96 to 21.30±6.70 at final follow-up). Significant improvement was
noted in local kyphosis angle (preoperative 22.14±2.60 to 10.40
±1.40 at postoperative) with a 10% loss of correction (2.5±0.90) at final
follow-up. There were no pseudoarthrosis and implant failure noted. No
iatrogenic dural or nerve injury. Superficial wound infection was noted in
two patients that was managed with debridement and antibiotics.
Conclusion: There is a high chance of implant failure in the osteoporotic
spine due to poor bone quality. Sublaminar mersilene tape augmented
pedicle screws fixation is a novel and low-cost modality for osteoporotic
vertebral compression fracture. It provides significant improvement in
clinical, radiological, and functional outcomes. It is an alternative option
for osteoporotic vertebral compression fractures fixation to avoid long
construct or cement related complications. A mersilene tape is radiolucent
material and does not affect postoperative MRI.