Volume 5 | Issue 1 | January-June 2020 | Page: 2-5 | Shailesh Hadgaonkar, Vivek Vincent, Pradhyumn Rathi, Parag Sancheti, Ashok Shyam
Authors : Shailesh Hadgaonkar , Vivek Vincent , Pradhyumn Rathi , Parag Sancheti , Ashok Shyam 
 Department of Spine, Sancheti Institute of Orthopedics and Rehabilitation
Address of Correspondence
Dr. Pradhyumn Rathi,
Row House No.1, Shamail complex, Balaji nagar, Bhayander west Thane 401101
Introduction: Osteoporotic vertebral compression fractures (OVCF) are one of the commonest fractures seen in day to day practise. We present a unique case of failure of pedicle screw instrumentation in OVCF revised by sublaminar wiring (SLW).
Case report: A 70 year old lady with old operated osteorporotic fracture with sagittal imbalance and implant loosening was revised with single spinal rectangular loop and sublaminar wires (SLW).
Conclusion: Pedicle screws constructs for short segment fixation are rigid and biomechanically superior with greatest pull out strength, which mainly depends on bone mineral density. But, sublaminar wires should be considered far more superior in severely osteoporotic bone.
Keywords: Bone density, Bone wires, Compression, Fractures, Osteoporosis, Pedical screws, Spinal fractures.
1. Bullmann V, Schmoelz W, Richter M, et al. Revision of cannulated and perforated cement-augmented pedicle screws: a biomechanical study in human cadavers. Spine 2010 ; 35 : E932–9.
2. Chang K-W, Chen Y-Y, Lin C-C, et al. Apical Lordosating Osteotomy and Minimal Segment Fixation for the Treatment of Thoracic or Thoracolumbar Osteoporotic Kyphosis. Spine 2005 : 1674–1681.
3. Coe JD, Warden KE, Herzig MA, et al. Influence of bone mineral density on the fixation of thoracolumbar implants. A comparative study of transpedicular screws, laminar hooks, and spinous process wires. Spine 1990 ; 15 : 902–907.
4. Cresswell TR, Marshall PD, Smith RB. Mechanical stability of the AO internal spinal fixation system compared with that of the Hartshill rectangle and sublaminar wiring in the management of unstable burst fractures of the thoracic and lumbar spine. Spine 1998 ; 23 : 111–115.
5. Faciszewski T, Winter RB, Lonstein JE, et al. The Surgical and Medical Perioperative Complications of Anterior Spinal Fusion Surgery in the Thoracic and Lumbar Spine in Adults. Spine 1995 : 1592–1599.
6. Glassman SD, Alegre GM. Adult spinal deformity in the osteoporotic spine: options and pitfalls. Instr Course Lect 2003 ; 52 : 579–588.
7. Hirabayashi S, Kumano K, Kuroki T. Cotrel-Dubousset pedicle screw system for various spinal disorders. Merits and problems. Spine 1991 ; 16 : 1298–1304.
8. Hodge WA, DeWald RL. Splenic injury complicating the anterior thoracoabdominal surgical approach for scoliosis. A report of two cases. The Journal of Bone & Joint Surgery 1983 : 396–397.
9. Luque ER. Interpeduncular segmental fixation. Clin OrthopRelat Res 1986 : 54–57.
10. McAfee PC. Complications of anterior approaches to the thoracolumbar spine. Emphasis on Kaneda instrumentation. Clin OrthopRelat Res 1994 : 110–119.
11. Mesfin A, Komanski CB, Jay Khanna A. Failure of Cement-Augmented Pedicle Screws in the Osteoporotic Spine. Geriatric Orthopaedic Surgery & Rehabilitation 2013 : 84–88.
12. Mohan AL, Das K. History of surgery for the correction of spinal deformity. Neurosurgical Focus 2003 : 1–5.
13. Moore DC, Maitra RS, Farjo LA, et al. Restoration of Pedicle Screw Fixation With an in Situ Setting Calcium Phosphate Cement. Spine 1997 : 1696–1705.
14. Nakai S, Zielke K. Chylothorax–a rare complication after anterior and posterior spinal correction. Report on six cases. Spine 1986 ; 11 : 830–833.
15. Parsons JR, Chokshi BV, Lee CK, et al. The biomechanical analysis of sublaminar wires and cables using luque segmental spinal instrumentation. Spine 1997 ; 22 : 267–273.
16. Patil S, Nene AM. Predictors of kyphotic deformity in osteoporotic vertebral compression fractures: a radiological study. Eur Spine J 2014 ; 23 : 2737–2742.
17. Patil SS, Bhojaraj SY, Nene AM. Safety and efficacy of spinal loop rectangle and sublaminar wires for osteoporotic vertebral compression fracture fixation. Asian J Neurosurg 2017 ; 12 : 436–440.
18. Weis JC, Betz RR, Clements DH 3rd, et al. Prevalence of perioperative complications after anterior spinal fusion for patients with idiopathic scoliosis. J Spinal Disord 1997 ; 10 : 371–375.
19. Wilber RG, Thompson GH, Shaffer JW, et al. Postoperative neurological deficits in segmental spinal instrumentation. A study using spinal cord monitoring. J Bone Joint Surg Am 1984 ; 66 : 1178–1187.
20. Yuan HA, Garfin SR, Dickman CA, et al. A Historical Cohort Study of Pedicle Screw Fixation in Thoracic, Lumbar, and Sacral Spinal Fusion. Spine 1994 : 2279S–2296S.
|How to Cite this Article: Hadgaonkar S, Vincent V, Rathi P, Sancheti P, Shyam A | Revision spine with Hartshill and Sublaminar wiring in operated osteoporotic fracture- A case note| International Journal of Spine| January-June 2020; 5(1): 2-5..