Minimally Invasive Spinal Arthrodesis in Osteoporotic Population Using a Cannulated and Fenestrated Augmented Screw: Technical Description and Clinical Experience
Table 3
Tips suggested to prevent PMMA cement extravasations.
An optimal positioning of the fenestrated pedicle screws is crucial
Screws must be placed in the middle of the pedicle to avoid cortical breaches
A good preoperative CT planning is recommended to select the correct diameter of screws
No injection if breaches suspected or if bicortical screw fixation
Start injection of cement when the high viscosity is obtained
Make injection under fluoroscopic control
Prefer the used of a controlled delivery system so as the V-MAX to be able to stop immediately the injection
Avoid to inject high volume of cement (we suggest 1.5 to 3 mL/screw)
