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Background Percutaneous pedicle screw technique is relatively a recent technique that evolved the concept of posterior spinal instrumentation, utilizing familiar fluoroscopic landmarks to guide the procedure of screws insertion, which despite being technically demanding, it avoids the Musculo-ligamentous damage associated with the conventional posterior technique. Aim of the work This study aims to report our experience in managing traumatic and degenerative spine pathologies by the minimally invasive percutaneous technique and assessing its radiological and functional outcome. Materials and methods A prospective observational study that included the analysis of the functional, operative, biochemical, and radiological outcomes of 20 patients who underwent uniplanar fluoroscopic-guided dorsal and/or lumbar percutaneous pedicle screw fixation procedures with or without fusion using the sextant, longitude, and Spineart system and any reported complications between January 2018 and December 2019. Results The clinical and radiological analysis of 100 percutaneous pedicle screws in degenerative (n:11) and traumatic (n:9) dorsal and/or lumbar cases revealed that the biomechanical stabilizing characteristics are comparable to the conventional posterior approach with the added benefits of the paraspinal muscle-sparing. Satisfactory functional outcome represented in the improvement of the postoperative back pain visual analog score and Oswestry Disability Index Score with acceptable morbidity and complications rate was noticed. Conclusions Percutanous pedicle screw fixation is a landmark in the evolution of the minimally invasive spine surgery which can be a safe alternative to the conventional posterior muscle stripping technique with a comparable functional and radiological outcome and good biomechanical profile and an acceptable morbidity rate.

Background This study aimed to assess the effect of intravenous lidocaine infusion affected on early postoperative pain control after complex spin surgeries. Ninety patients who were scheduled for complex spine surgery were included in this prospective double-blinded controlled trial. They were randomly assigned to one of two groups: L and P. Patients in group L received a loading dose of lidocaine 1 mg/kg then followed by 1.5 mg/kg/h infusion till the end of the surgery, while in group P, lidocaine was replaced with normal saline. Results The pain score assessed by VAS at rest showed statistically significant lower values in group L at 30 min, 8, 12, and 24 h postoperatively. VAS during movement was significantly higher in group P only after 24 h postoperatively. The entire dose of intraoperative fentanyl consumed was significantly lower in group L. The time elapsed to ask for the first dose of rescue analgesia was significantly longer in group L. The first rescue dose of nalbuphine was significantly lower in group L. In group P, the overall dose of narcotics consumed in the first postsurgical day was significantly higher. Conclusions When compared to placebo, lidocaine infusion significantly reduced the postoperative pain scores, as well as the entire dose of intraoperative and postoperative narcotics used.