A Biomechanical Comparison of Facet Screw Fixation and Pedicle Screw Fixation

Ferrara, Lisa; Secor, Jessica L.; Jin, Byung Ho; Wakefield, A.R.; İnceoğlu, Serkan; Benzel, Edward C.

doi:10.1097/01.brs.0000065485.46539.17

Cited by 97 publications

(77 citation statements)

References 27 publications

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“…10,11,24 Concerns were raised regarding the solidarity of facet screw fixation and several studies confirmed the adequate vertebral fixation using this technique. Benzel EC et al, 3 found that the stability provided by both trans-facet pedicle screw (TFPS) fixation and traditional pedicle screw fixation was not compromised after repetitive cycling. In this model, trans-facet screw fixation appears equivalent biomechanically to traditional pedicle screw fixation.…”

Section: Discussionmentioning

confidence: 99%

“…Translaminar facet screw fixation was also used and was thought to have better fixation properties than direct facet screws because it fixed a longer segment of bone including the lamina and the facet joint. 2,4,9,25,28 Percutaneous facet screw fixation system was also invented, however, it is expensive, uses the C-arm guidance and only used for cases of instability not requiring discectomy or foraminotomy. 12,15 In this study, we evaluate the role of bilateral facet screw fixation together with posterior lumbar interbody fusion (PLIF) using autologous bone graft as an easy and cheap means for reducing or preventing postoperative instability and recurrence of disc prolapse after lumbar discectomy.…”

Section: 813mentioning

confidence: 99%

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Bilateral Lumbar Facet Screw Fixation and Posterior Lumbar Interbody Fusion in Lumbar Disc Prolapse

Moussa¹,

Khedr²

2016

Egyptian Spine Journal

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Background Data: Lumbar disc prolapse is a common neurosurgical diagnosis. A trial of medical treatment, bed rest and physiotherapy is tried at first. Surgical treatment is resorted to if conservative treatment fails. However, postoperative complications including recurrent lumbar disc prolapse, postlaminectomy spondylolisthesis and failed back syndrome can occur. This is usually caused by instability at the discectomy level. In a trial to reduce these complications, we will use posterior lumbar interbody fusion together with bilateral facet screw fixation implanted during discectomy to reduce postoperative instability. Purpose: To study the effect of posterior lumbar interbody fusion with bilateral facet screw fixation to decrease the incidence of postoperative complications. Study Design: A prospective randomized controlled trial including 40 patients. Patients and Methods: Forty patients diagnosed with lumbar disc prolapse causing sciatic pain with or without lower limb weakness not responding to conservative treatment were included in the study. Twenty patients (group A) was submitted to PLIF together with bilateral facet screw fixation after having conventional lumbar laminectomy and discectomy, while 20 other patients (group B) was submitted only to conventional lumbar laminectomy and discectomy and will be used as controls.

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Section: Discussionmentioning

confidence: 99%

Section: 813mentioning

confidence: 99%

Bilateral Lumbar Facet Screw Fixation and Posterior Lumbar Interbody Fusion in Lumbar Disc Prolapse

Moussa¹,

Khedr²

2016

Egyptian Spine Journal

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“…[2][3][4] Ferrera and colleagues reached this same conclusion and observed a decrease in fl exion potential in systems reliant upon transfacet fi xation, a possible benefi t for inter-body arthrodesis. 5 Various authors have assessed similar fusion constructs for bony fusion at 6 to 24 months. 6 It is encouraging that each of our patients exhibited evidence of solid fusion at only four months, a sign of rigid fi xation.…”

Section: Discussionmentioning

confidence: 99%

Ipsilateral pedicle screw placement with contralateral percutaneous facet screws: Early results with an alternative in lumbar arthrodesis

Lozen¹

2009

OAS

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Abstract:Transforaminal lumbar interbody fusion (TLIF) is a widely used method of surgical treatment for a variety of lumbar spinal disorders. Bilateral transpedicular instrumentation is routinely used in conjunction with an interbody graft to provide additional stability. In this technical note, we describe our fusion construct using ipsilateral pedicle screw placement on the side of TLIF and contralateral facet screw placement. We performed this construct at six levels in four patients. Suggested advantages include: low morbidity, small incision and lower cost. Outcomes parameters included radiographic evidence of solid union at four months and improvement in Oswestry Disability Index. A mean improvement from a preoperative score of 73 to 26 after surgery was observed at one-year follow-up. There were no instrument-related complications. In conclusion, this hybrid screw system minimizes contralateral dissection and is an attractive alternative to standard bilateral pedicle screw fi xation.

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“…Throughout this development, the pedicle screw continues to be the mainstay for posterior fixation. 5,7,23,25 A properly placed pedicle screw spans all 3 columns of the spine. 5,25 The purchase…”

Section: Discussionmentioning

confidence: 99%

Minimally invasive guidewireless, navigated pedicle screw placement: a technical report and case series

Smith

Joseph

Kirsch

et al. 2017

Neurosurgical Focus

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OBJECTIVEPercutaneous pedicle screw insertion (PPSI) is a mainstay of minimally invasive spinal surgery. Traditionally, PPSI is a fluoroscopy-guided, multistep process involving traversing the pedicle with a Jamshidi needle, placement of a Kirschner wire (K-wire), placement of a soft-tissue dilator, pedicle tract tapping, and screw insertion over the K-wire. This study evaluates the accuracy and safety of PPSI with a simplified 2-step process using a navigated awl-tap followed by navigated screw insertion without use of a K-wire or fluoroscopy.METHODSPatients undergoing PPSI utilizing the K-wire–less technique were identified. Data were extracted from the electronic medical record. Complications associated with screw placement were recorded. Postoperative radiographs as well as CT were evaluated for accuracy of pedicle screw placement.RESULTSThirty-six patients (18 male and 18 female) were included. The patients’ mean age was 60.4 years (range 23.8–78.4 years), and their mean body mass index was 28.5 kg/m2 (range 20.8–40.1 kg/m2). A total of 238 pedicle screws were placed. A mean of 6.6 pedicle screws (range 4–14) were placed over a mean of 2.61 levels (range 1–7). No pedicle breaches were identified on review of postoperative radiographs. In a subgroup analysis of the 25 cases (69%) in which CT scans were performed, 173 screws were assessed; 170 (98.3%) were found to be completely within the pedicle, and 3 (1.7%) demonstrated medial breaches of less than 2 mm (Grade B). There were no complications related to PPSI in this cohort.CONCLUSIONSThis streamlined 2-step K-wire–less, navigated PPSI appears safe and accurate and avoids the need for radiation exposure to surgeon and staff.

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A Biomechanical Comparison of Facet Screw Fixation and Pedicle Screw Fixation

Abstract: The stability provided by both transfacet pedicle screw fixation and traditional pedicle screw fixation was not compromised after repetitive cycling. In this model, transfacet pedicle screw fixation appears equivalent biomechanically to traditional pedicle screw fixation.

Cited by 97 publications

References 27 publications

Bilateral Lumbar Facet Screw Fixation and Posterior Lumbar Interbody Fusion in Lumbar Disc Prolapse

Bilateral Lumbar Facet Screw Fixation and Posterior Lumbar Interbody Fusion in Lumbar Disc Prolapse

Ipsilateral pedicle screw placement with contralateral percutaneous facet screws: Early results with an alternative in lumbar arthrodesis

Minimally invasive guidewireless, navigated pedicle screw placement: a technical report and case series

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