Cortical bone trajectory screws fixation in lumbar adjacent segment disease: A technique note with case series

J Clin Neurosci. 2018 Feb:48:224-228. doi: 10.1016/j.jocn.2017.11.008. Epub 2017 Dec 6.

Abstract

Lumbar adjacent segment disease after lumbar fusion surgery often requires surgical intervention. However, subsequent surgical treatment often needs to expose and remove all of the previous instruments. This additional surgery leads to significant post-operative pain, muscular fibrosis, poor wound healing and infection, etc. From October 2015 to March 2016, we collected six cases underwent cortical bone trajectory screws fixation with minimal invasive inter-body cage fusion for lumbar adjacent segment disease. Patients in the study all had improvement after surgery without recurrence or instruments failure during follow-up. The technique negates removal of pre-existing instruments and when combined with minimal invasive fusion surgery, the wound length, blood loss and soft tissue damage could be reduced compared with traditional surgery. We introduce the surgical procedures in detail and wish this technique could be an option for spine surgeons who encounter a similar situation.

Keywords: Cortical bone trajectory screw fixation; Lumbar adjacent segment disease; Pedicle screw; Stand-alone cage fusion.

MeSH terms

  • Adult
  • Aged
  • Cortical Bone / surgery*
  • Female
  • Humans
  • Lumbar Vertebrae / surgery*
  • Male
  • Middle Aged
  • Minimally Invasive Surgical Procedures / methods
  • Neurosurgical Procedures / methods*
  • Pedicle Screws*
  • Spinal Fusion / methods*