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A screw position change at an early postoperative stage preceding the subsequent occurrence of screw loosening

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Abstract

Purpose

The authors recently proposed the novel radiologic assessment method to measure chronological screw position changes precisely. The aim of this study was to predict the late occurrence of screw loosening, which was diagnosed by the radiographic lucent zone, by evaluating screw position changes at an early postoperative stage using the novel method.

Methods

Forty-three patients who underwent thoracolumbar screw fixation and follow-up computed tomography (CT) scans on the day, between 1 and 5 weeks, and at more than 6 months after surgery were retrospectively evaluated. Screw images were generated from CT data. Screw position changes were evaluated by superposing screw images on the day and between 1 and 5 weeks after surgery. Screw loosening was diagnosed by the radiographic lucent zone on CT images at 6 months or later post-surgery, and patients were classified into screw loosening and non-loosening groups. The early screw position changes were compared between the two groups.

Results

Significant differences in early screw position changes were found between the screw loosening and non-loosening groups in Mann–Whitney U test (p = 0.001). On the receiver operating characteristic (ROC) curve analysis, the area under the ROC curve was 0.791, and the best cutoff value of early screw position change for the prediction of screw loosening was 0.83 mm with a sensitivity of 64.0% and a specificity of 88.9%.

Conclusion

We calculated a cutoff value of the screw position changes at an early postoperative stage for the prediction of subsequent development of screw loosening with the radiographic lucent zone.

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Authors and Affiliations

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

    Satoru Tanioka, Fujimaro Ishida, Masanori Tsuji & Katsuhiro Tanaka

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

    Masashi Fujimoto, Keita Kuraishi, Hidenori Suzuki & Masaki Mizuno

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

    Hirofumi Nishikawa

  4. Department of Neurosurgery, Mie Prefectural General Medical Center, 5450-132 Oaza Hinaga, Yokkaichi, Mie, 510-8561, 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. Fujimaro Ishida
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  5. Masanori Tsuji
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  6. Katsuhiro Tanaka
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  7. Yusuke Kamei
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  8. Keita Kuraishi
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  9. Hidenori Suzuki
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  10. Masaki Mizuno
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Corresponding author

Correspondence to Satoru Tanioka.

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Conflict of interest

Satoru Tanioka, Masashi Fujimoto, Hirofumi Nishikawa, Fujimaro Ishida, Masanori Tsuji, Katsuhiro Tanaka, Yusuke Kamei, Keita Kuraishi, Hidenori Suzuki, and Masaki Mizuno declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional research committee (Mie Chuo Medical Center IRB [MCERB-201848] and Mie University Hospital IRB [T2019-6]) and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Tanioka, S., Fujimoto, M., Nishikawa, H. et al. A screw position change at an early postoperative stage preceding the subsequent occurrence of screw loosening. Eur Spine J 30, 136–141 (2021). https://doi.org/10.1007/s00586-020-06510-8

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  • DOI: https://doi.org/10.1007/s00586-020-06510-8

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