Patient Selection and Reoperation After Cement-Augmented Pedicle Screw Fixation in the Thoracolumbar Spine: A Single-Center Cohort

Background/Objectives: Poor bone quality compromises pedicle screw fixation, and cement augmentation of fenestrated screws improves fixation at the screw–bone interface. Whether low interface-failure rates translate into low all-cause reoperation rates in routine practice is not established. We characterized the institutional use of cement-augmented fenestrated pedicle screws, the retrospectively measured vertebral computed tomography (CT) attenuation of selected patients, and subsequent interface failure and reoperation.

Methods

We reviewed all patients undergoing thoracolumbar pedicle screw fixation between January 2016 and June 2022 at one tertiary referral center. Vertebral attenuation was measured retrospectively in Hounsfield units (HU) at L1 through L4. Outcome proportions are reported with Wilson 95% confidence intervals. Comparisons across surgical indications used exact tests with Holm correction and were treated as exploratory. Cement leakage and other cement-specific safety events could not be ascertained and were not study outcomes.