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Radiolucent Zone around Screws is Associated with Position Change of Screw-rod Constructs

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Abstract

Purpose

A radiologic assessment method to measure position change of screw-rod constructs over time by superposing the 3‑dimensional images assists in quantitative evaluation of screw loosening. We investigated the association between position change and radiolucent zone that was commonly used for diagnosing screw loosening.

Methods

In this study 101 patients who underwent lumbar fusion were reviewed. Patient characteristics included age, sex, indications for surgery, number of fused levels, surgical procedures, and timing of follow-up computed tomography (CT, 1–5 months, 6–11 months, and ≥ 12 months). The Hounsfield unit values of L1 vertebra on preoperative CT were measured, and the radiolucent zone on each follow-up CT was evaluated. Using baseline CT on the day after surgery and follow-up CT, 3‑dimensional images of screw-rod constructs were generated and superposed. Position change was assessed by the median of the distances between the 3‑dimensional images at baseline and follow-up using the automated measurement method. Patient characteristics, the Hounsfield unit values of L1, and the amount of position change were categorized into the radiolucent zone presence and absence groups and compared.

Results

The medians of position change were 0.281 mm and 0.136 mm in the radiolucent zone presence and absence groups, respectively (P < 0.001 by Mann-Whitney U-test). The area under the curve for position change in identifying radiolucent zone was 0.846; the cut-off value was 1.76 mm. In multivariable analysis, position change was independently associated with radiolucent zone (adjusted odds ratio per 0.1 mm, 2.80, 95% confidence interval 1.70–4.61).

Conclusion

Radiolucent zone was associated with position change of screw-rod constructs.

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Authors and Affiliations

  1. Department of Neurosurgery, Mie Chuo Medical Center, 2158-5 Myojin-cho, 514-1101, Hisai, Tsu, Mie, Japan

    Satoru Tanioka, Katsuhiro Tanaka & Fujimaro Ishida

  2. Department of Neurosurgery, Mie University Graduate School of Medicine, 2-174 Edobashi, 514-8507, Tsu, Mie, Japan

    Masashi Fujimoto, Hirofumi Nishikawa, Atsushi Yamamoto, Hidenori Suzuki & Masaki Mizuno

  3. Department of Neurosurgery, Suzuka Kaisei Hospital, 112-1 Ko-cho, 513-8505, Suzuka, Mie, Japan

    Munenari Ikezawa

  4. Department of Neurosurgery, Mie Prefectural General Medical Center, 5450-132 Oaza Hinaga, 510-8561, Yokkaichi, Mie, Japan

    Yusuke Kamei

Authors
  1. Satoru Tanioka
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  2. Masashi Fujimoto
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  3. Hirofumi Nishikawa
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  4. Katsuhiro Tanaka
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  5. Fujimaro Ishida
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  6. Atsushi Yamamoto
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  7. Munenari Ikezawa
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  8. Yusuke Kamei
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  9. Hidenori Suzuki
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  10. Masaki Mizuno
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Contributions

Author Contribution

Satoru Tanioka and Fujimaro Ishida contributed to the study conception and design. Material preparation and data collection were performed by Satoru Tanioka, Katsuhiro Tanaka, Atsushi Yamamoto, Munenari Ikezawa, and Yusuke Kamei. Data analysis was performed by Satoru Tanioka, Masashi Fujimoto, Hirofumi Nishikawa, Hidenori Suzuki, and Masaki Mizuno. The first draft of the manuscript was written by Satoru Tanioka and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

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Corresponding author

Correspondence to Satoru Tanioka.

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Conflict of interest

S. Tanioka, M. Fujimoto, H. Nishikawa, K. Tanaka, F. Ishida, A. Yamamoto, M. Ikezawa, Y. Kamei, H. Suzuki and M. Mizuno declare that they have no competing interests.

Ethical standards

The Institutional Review Boards granted approval for the present study. All study protocols and procedures were conducted in accordance with the Declaration of Helsinki. Consent to participate: this was a retrospective study: therefore, separate informed patient consent was not required. Consent for publication: not applicable.

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Tanioka, S., Fujimoto, M., Nishikawa, H. et al. Radiolucent Zone around Screws is Associated with Position Change of Screw-rod Constructs. Clin Neuroradiol 32, 717–724 (2022). https://doi.org/10.1007/s00062-021-01132-z

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  • DOI: https://doi.org/10.1007/s00062-021-01132-z

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