A comparative study of lumbar spine stabilization with 2-stage surgery and cement augmentation in osteoporosis patients: a randomized clinical trial

Sci Rep. 2025 Feb 12;15(1):5226. doi: 10.1038/s41598-024-80845-w.

Abstract

The biggest challenge for osteoporotic patients after spinal stabilization is screw loosening. Therefore, the present study was conducted with the comparative aim of stabilizing the lumbar spine with 2-stage surgery and cement augmentation in osteoporotic patients. 66 patients selected through convenience sampling and randomly assigned to two groups: CAPS and 2-stage surgery. In the CAPS group, lumbar spine fixation was performed in a single stage, accompanied by cement augmentation. In the 2-stage surgery group, spinal stabilization was conducted in 2 stages. In the first stage, pedicle screws were implanted, followed by the pedicle screw anchoring process 6 months later. fusion rate, screw loosening, pain levels (VAS), and patients' disability (ODI) were measured in each group. The fusion rate in the 2-stage Surgery group significantly increased. Screw loosening in the CAPS group showed a significantly higher difference. The rate of pain and disability in patients early postoperatively, in comparison to preoperative measures, significantly decreased in both groups. In the final follow-up, the CAPS group experienced a significant increase in pain and disability. The 2-stage Surgery stabilization, when compared to the CAPS technique, demonstrates superiority in enhancing the biomechanical stability of screws and achieving successful fusion.

Keywords: Bone cemente; Fusion; Osteoporosis; Spine; Stabilization.

Publication types

  • Randomized Controlled Trial
  • Comparative Study

MeSH terms

  • Aged
  • Bone Cements* / therapeutic use
  • Female
  • Humans
  • Lumbar Vertebrae* / surgery
  • Male
  • Middle Aged
  • Osteoporosis* / surgery
  • Pedicle Screws*
  • Spinal Fusion* / methods
  • Treatment Outcome

Substances

  • Bone Cements