Transforaminal Vertebroplasty for Screwed Vertebrae: A New Minimally Invasive Technique

Pedicle screw loosening and fractures of instrumented vertebrae are not uncommon and require reoperations, which are an immense burden on the patient and health care system. We aimed to describe a novel, simple percutaneous technique on instrumented vertebrae for treating pedicle screw loosening and demonstrate that corpus with osteoporotic vertebral compression fractures can be managed with this simple technique.

This retrospective study was performed using data gathered from 15 patients who underwent transforaminal vertebroplasty due to symptomatic pedicle screw loosening and vertebral body fracture between 2020 and 2021. Patients' symptoms, radiologic findings, intraoperative findings, and clinical outcomes were noted.

This series consisted of 5 male and 10 female patients, and the mean duration of follow-up was 8 months (range: 3 to 13). The average age was 66.67 ± 4.59 years (range: 55-72). Preoperatively, symptoms were leg pain, numbness of the lower extremity, and back pain. Postoperatively, no major complications were observed. Clinical progression of pedicle screw loosening and osteoporotic vertebral compression fractures were halted in all patients. None of the patients had permanent neurologic deficits. All the patients reported a dramatic decrease in pain immediately after the procedure. The vertebral fracture was detected in 3 patients, and screw loosening occurred in 12 patients. All symptoms resolved during follow-up.

Our preliminary results imply that transforaminal vertebroplasty is a safe and easy percutaneous technique in symptomatic pedicle screw loosening and osteoporotic vertebral compression fractures in the instrumented vertebrae. Further trials on larger series are necessary to validate our data.