Lumbar Spinal Fixation with Cortical Bone Trajectory Pedicle Screws in 79 Patients with Degenerative Disease: Perioperative Outcomes and Complications

Snyder, Laura A.; Martinez-del-Campo, Eduardo; Neal, Matthew T.; Zaidi, Hasan A.; Awad, Al-Wala; Bina, Robert; Ponce, Francisco A.; Kaibara, Taro; Chang, Steve

doi:10.1016/j.wneu.2015.12.065

Cited by 49 publications

(28 citation statements)

References 31 publications

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“…18 Insertional torque was found to be almost twice as high for the cortical bone trajectory pedicle screws than for traditional trajectory pedicle screws. 13 In another study 23 of 79 adults with degenerative lumbosacral disease, the authors demonstrated that the use of cortical bone trajectory pedicle screws was associated with acceptable operative outcomes with a low complication rate. There were no complications directly related to screw placement except for pars and pedicle fractures and early screw loosening.…”

Section: Discussionmentioning

confidence: 98%

Feasibility and safety of using thoracic and lumbar cortical bone trajectory pedicle screws in spinal constructs in children: technical note

Sellin

Raskin

Staggers

et al. 2018

Journal of Neurosurgery: Pediatrics

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Thoracic and lumbar cortical bone trajectory pedicle screws have been described in adult spine surgery. They have likewise been described in pediatric CT-based morphometric studies; however, clinical experience in the pediatric age group is limited. The authors here describe the use of cortical bone trajectory pedicle screws in posterior instrumented spinal fusions from the upper thoracic to the lumbar spine in 12 children. This dedicated study represents the initial use of cortical screws in pediatric spine surgery.The authors retrospectively reviewed the demographics and procedural data of patients who had undergone posterior instrumented fusion using thoracic, lumbar, and sacral cortical screws in children for the following indications: spondylolysis and/or spondylolisthesis (5 patients), unstable thoracolumbar spine trauma (3 patients), scoliosis (2 patients), and tumor (2 patients).Twelve pediatric patients, ranging in age from 11 to 18 years (mean 15.4 years), underwent posterior instrumented fusion. Seventy-six cortical bone trajectory pedicle screws were placed. There were 33 thoracic screws and 43 lumbar screws. Patients underwent surgery between April 29, 2015, and February 1, 2016. Seven (70%) of 10 patients with available imaging achieved a solid fusion, as assessed by CT. Mean follow-up time was 16.8 months (range 13–22 months). There were no intraoperative complications directly related to the cortical bone trajectory screws. One patient required hardware revision for caudal instrumentation failure and screw-head fracture at 3 months after surgery.Mean surgical time was 277 minutes (range 120–542 minutes). Nine of the 12 patients received either a 12- or 24-mg dose of recombinant human bone morphogenic protein 2. Average estimated blood loss was 283 ml (range 25–1100 ml).In our preliminary experience, the cortical bone trajectory pedicle screw technique seems to be a reasonable alternative to the traditional trajectory pedicle screw placement in children. Cortical screws seem to offer satisfactory clinical and radiographic outcomes, with a low complication profile.

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Section: Discussionmentioning

confidence: 98%

Feasibility and safety of using thoracic and lumbar cortical bone trajectory pedicle screws in spinal constructs in children: technical note

Sellin

Raskin

Staggers

et al. 2018

Journal of Neurosurgery: Pediatrics

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show abstract

“…The two most widespread systems used for primary spinal stabilization are transpedicular fixation with screws and rods and an interspinous device. [25][26][27][28][29] Microdiscetomy and fusion are the most common surgical options used to treat LDD, with or without segmental instability. However, the clinical success of fusion varies widely (16-95%), and it mainly depends on the indication criteria used.…”

Section: Discussionmentioning

confidence: 99%

Preliminary Experience with a Novel System of Facet Fixation to Treat Patients with Lumbar Degenerative Disease. A New Perspective in Minimally Invasive Spine Surgery?

Francaviglia

Costantino

Villa

et al. 2017

J Neurol Surg A Cent Eur Neurosurg

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“…However, there are still risks and postoperative complications in clinical practice, including failure of internal fixation, pedicle splitting, pseudarthrosis and dural tear. Some scholars [17][18][19] pointed out that the early complications of CBT screw technology mainly included postoperative screw loosening, intraoperative articular process fracture, dura mater breakage and pedicle splitting.…”

Section: Development Change and Limitation Of Spinal Fixation Technomentioning

confidence: 99%

Imaging anatomy and clinical significance of percutaneous endoscopic transforaminal oblique fixation from posterior corner in lumbar spine

Chen

Liu

Sun

et al. 2020

Preprint

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BackgroundPercutaneous endoscopic transforaminal lumbar interbody fusion (PE-TLIF) has been widely discussed due to its advantages of less trauma, less bleeding, quick recovery, high safety, and relatively fewer complications, as well as other adverse factors such as incomplete decompression, steep learning curve, low fusion rate, and high radiation risk. It can keep the posterior structure of spine intact to the greatest extent, ensure the stability of spine after surgery, and achieve decompression with minor trauma. However, posterior percutaneous pedicle screws are often needed for fusion and fixation after decompression, and additional posterior trauma, postural changes and anesthesia methods are often required. Interbody fixation and fusion are often independent and not one-stop completion. The authors consider whether the percutaneous spinal endoscopy can be used to achieve complete decompression and fusion under a single minimally invasive channel, while achieving one-stop endoscopic decompression, fusion and fixation. The purpose of this paper is to provide the anatomic feasibility for oblique fixation by measuring the imaging anatomic parameters, especially to provide the anatomic basis for the design of new endoscopic lumbar interbody fusion cage.Methods Sixty volunteers (22 men and 38 women) who underwent lumbar CT scans were collected and sent to the GEAW4.4 workstation. The distances from posterior corner in the lumbar spine to the corresponding targets of the contralateral anterior corner and the included angles between each path line in sagittal and axial plane were measured and analyzed statistically.Results In the medium group, PC path was the shortest, PA path and PB path had little difference (P=0.123), with no statistical significance. In the full-length group, PF path was the shortest, and there was no significant difference between PD path and PE path (P =0.177). PE was the optimal path. The included angles a1, a2, a3, b1, b2, and b3 in sagittal plane and c1, c2 and c3 in axial plane were significantly different (P=0.000), namely, a1 >a2>a3, b1>b2>b3, and c1<c2<c3. Conclusions This study provides anatomic feasibility for percutaneous endoscopic transforaminal oblique fixation from posterior corner in lumbar spine and particularly provides anatomic basis for the design of new endoscopic lumbar interbody fusion cage.

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Lumbar Spinal Fixation with Cortical Bone Trajectory Pedicle Screws in 79 Patients with Degenerative Disease: Perioperative Outcomes and Complications

Cited by 49 publications

References 31 publications

Feasibility and safety of using thoracic and lumbar cortical bone trajectory pedicle screws in spinal constructs in children: technical note

Feasibility and safety of using thoracic and lumbar cortical bone trajectory pedicle screws in spinal constructs in children: technical note

Preliminary Experience with a Novel System of Facet Fixation to Treat Patients with Lumbar Degenerative Disease. A New Perspective in Minimally Invasive Spine Surgery?

Imaging anatomy and clinical significance of percutaneous endoscopic transforaminal oblique fixation from posterior corner in lumbar spine

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