Midline lumbar fusion using cortical bone trajectory screws. Preliminary report.

Bielecki, M; Kunert, Przemysław; Prokopienko, Marek; Nowak, Arkadiusz; Czernicki, Tomasz; Marchel, Andrzej

doi:10.5114/wiitm.2016.62289

Cited by 4 publications

(2 citation statements)

References 14 publications

(19 reference statements)

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“…The CBT screws are thinner and shorter than PSs, which enables them to access higher-density cortical bone. 2 The proposed benefits of CBT screws include decreased approach-related morbidity and greater cortical bone contact, which theoretically reduces screw pullout. 3 The latter is especially important in patients with low bone mineral density who are at higher risk of pseudarthrosis.…”

Section: Introductionmentioning

confidence: 99%

Comparison of Cortical Bone Trajectory Screw Placement Using the Midline Lumbar Fusion Technique to Traditional Pedicle Screws: A Case-Control Study

et al. 2019

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Background: Cortical bone trajectory (CBT) screws are an alternative to traditional pedicle screws (PS) for lumbar fixation. The proposed benefits of CBT screws include decreased approach-related morbidity and greater cortical bone contact to prevent screw pullout. Relatively little data is published on this technique. Here, we compare the midline lumbar fusion (MIDLF) approach for CBT screw placement to transforaminal lumbar interbody fusion (TLIF) for traditional PS placement. Methods: A prospectively maintained institutional database was retrospectively reviewed for all patients undergoing lumbar spinal fusion using CBT screws over the past 5 years. Controls were identified from the same database as patients undergoing lumbar spinal fusion with traditional PS placement and matched based on age, sex, and number of levels fused. Exclusion criteria included prior lumbar instrumentation. The electronic health record was retrospectively reviewed for demographic, perioperative, and postoperative data. Results: A total of 23 patients who underwent CBT screw placement and 35 controls who received traditional PS were included in the study. The median follow-up time was 52.5 months. The CBT screw group had significantly less mean estimated blood loss than the PS group (186 mL versus 414 mL respectively; P ¼ .008). Both groups experienced significant improvements in preoperative Oswestry Disability Index (ODI) and visual analog scale (VAS) scores for back and leg pain. However, there was no significant difference between the groups in regard to operative time and amount of improvement in VAS pain score or ODI. The CBT group was associated with a significantly shorter mean length of stay (LOS). There were 2 instances of screw pullout in each group. Conclusions: The MIDLF approach with CBT screw placement is associated with less intraoperative blood loss and shorter LOS than traditional PS placement. There is no difference between the 2 techniques in regard to improvement in pain or disability.

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Section: Introductionmentioning

confidence: 99%

Comparison of Cortical Bone Trajectory Screw Placement Using the Midline Lumbar Fusion Technique to Traditional Pedicle Screws: A Case-Control Study

et al. 2019

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“…In order to solve the clinical problem, Cortical bone channel (cortical bone trajectory, CBT) scheme was suggested by Santoni et al in 2009 and applied to the lumbar pedicle nailing [11]. Compared with PS, CBT screw has the characteristics of smaller diameter, shorter length and tighter thread [12,13]. The screw is placed at an inward and outward tilt to maximize the contact with cortical bone.…”

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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Midline lumbar interbody fusion (MIDLIF) with cortical screws: initial experience and learning curve

Silva

Vaz

et al. 2019

Acta Neurochir

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Midline lumbar fusion using cortical bone trajectory screws. Preliminary report.

Cited by 4 publications

References 14 publications

Comparison of Cortical Bone Trajectory Screw Placement Using the Midline Lumbar Fusion Technique to Traditional Pedicle Screws: A Case-Control Study

Comparison of Cortical Bone Trajectory Screw Placement Using the Midline Lumbar Fusion Technique to Traditional Pedicle Screws: A Case-Control Study

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

Midline lumbar interbody fusion (MIDLIF) with cortical screws: initial experience and learning curve

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