Evaluating the Necessity of Screw Replacement in Sacral Bone Loosening: A Minimally Invasive Approach for Treatment with Local Anesthesia

Abstract

Background This study aimed to investigate a minimally invasive approach to address the issue of bone loosening in patients who have undergone posterior spinal fusion surgery. If left untreated, sacral bone loosening can result in nerve damage, reduced mobility, and chronic pain. The standard surgical treatment involves replacing the loosened screw with a larger one, requiring significant surgical intervention and complete instrument disassembly. The use of polymethylmethacrylate (PMMA) to increase the strength of the vertebral body was also described, but the results were contradictory. We aim to evaluate the efficacy of filling just only the gap between bone and screw instead of the vertebral body.

Keywords

• bone loosening
• screw loosening
• polymethylmethacrylate
• fusion insufficiency