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

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.