Unilateral pedicle screw fixation of lumber spine: A safe internal fixation method

Yang, Simengge; Xia, Honggang; Cong, Menglin; Guo, Anyun; Ma, Kai; Song, Mingzhi

doi:10.1016/j.heliyon.2022.e11621

Cited by 4 publications

(3 citation statements)

References 54 publications

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“…Unilateral pedicle screw fixation has advantages of decrease in operative time, length of hospital stays and blood loss with similar biomechanical advantage to bilateral pedicle screw fixation [20,21]. Recently, Yang et al [22] through their biomechanical study using finite element model and calf lumbar model, concluded that unilateral pedicle screw fixation is considered a safe and reliable technique. However, unilateral pedicle screw fixation has a disadvantage of increased cage migration, which is not applicable to our cases.…”

Section: Discussionmentioning

confidence: 99%

Osteoid Osteomas of Spine: From Open to Minimally Invasive Excision of the Nidus – A Case series

Ganesh Kumar,

V.N,

Raju

et al. 2023

ijs

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Osteoid osteomas of spine are not uncommon and majority of which occurs in posterior elements of lumbar spine. Management of such lesions in spine ranges from open en bloc excision to percutaneous radiofrequency ablation. In this series, we have managed three cases of osteoid osteomas of spine, each managed differently from conventional open technique to minimally invasive method. All three cases underwent appropriate radiological investigations and followed by surgical excision of the lesion and histopathological analysis post-operatively. First case was managed with open excision of the lesion with conventional unilateral pedicle screw stabilisation. Second case, who underwent open excision of the lesion developed recurrence which was managed by re-excision without any further complications. Last case underwent microendoscopic quadrant tubular excision of the tumour with unilateral MISS with pedicle screws. The technique of Microendoscopic quadrant tubular excision of posterior element benign tumour had advantages of small skin incision, less bleeding, clear macroscopic visualisation of the small tumour (enables complete excision of the nidus thus decreasing the recurrence), early mobilisation and shorter hospitalization with effective and complete excision of the tumour better than open method. Further, histological evidence of tumour will be available. The complete excision of nidus using microendoscopic tubular retractors with unilateral fixation in young age gives encouraging results. This case series is followed by review of literature highlighting the role of COX-2 inhibitors in osteoid osteoma, cause for scoliosis and neurological deficit in osteoid osteoma and management of osteoid osteomas of spine. Keywords: Tumor, Osteoid osteoma, Minimally invasive, Dorsolumbar spine, Excision biopsy

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Section: Discussionmentioning

confidence: 99%

Osteoid Osteomas of Spine: From Open to Minimally Invasive Excision of the Nidus – A Case series

Ganesh Kumar,

V.N,

Raju

et al. 2023

ijs

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“…Currently, for the spinal internal fixation, pedicle screws plus connecting rod system is commonly used instrumentation and the gold standard for all spinal segments from the cervical to sacral spine. [8][9][10][11] Literature shows that the shape of the connecting rod can directly affect the stability of the screw-rod gripping capability and the postoperative spinal stability. [12][13][14][15][16] The shape of the connecting rod is determined by the locations of the ipsilateral screw tails and the flexible range of the tail caps.…”

Section: Introductionmentioning

confidence: 99%

“…Improper screw placement can lead to serious complications, including paralysis, blood loss, even death. Currently, for the spinal internal fixation, pedicle screws plus connecting rod system is commonly used instrumentation and the gold standard for all spinal segments from the cervical to sacral spine 8‐11 . Literature shows that the shape of the connecting rod can directly affect the stability of the screw‐rod gripping capability and the postoperative spinal stability 12‐16 .…”

Section: Introductionmentioning

confidence: 99%

Pedicle screw path planning for multi‐level vertebral fixation

Zhao,

Zhang,

Zhan

et al. 2024

Medical Physics

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BackgroundFor the spinal internal fixation procedures, connecting rods to the pedicle screws are commonly used in all spinal segments from the cervical to sacral spine. So far, we have only seen single vertebral screw trajectory planning methods in literatures. Joint screw placements in multi‐level vertebrae with the constraint of an ipsilateral connecting rod are not considered.PurposeIn this paper, a screw trajectory planning method that considers screw‐rod joint system with both multi‐level vertebral constraints and individual vertebral safety tolerance are proposed.MethodsThe proposed method addresses three challenging constraints jointly for multi‐level vertebral fixation with pedicle screws. First, a cylindrical screw safe passage model is suggested instead of a unique mathematical optimal trajectory for a single pedicle. Second, the flexible screw cap accessibility model is also included. Third, the connecting rod is modeled to accommodate the spine contour and support the needed gripping capacity. The retrospective clinical data of relative normal shape spines from Beijing Jishuitan hospital were used in the testing. The screw trajectories from the existing methods based on single vertebra and the proposed method based on multi‐level vertebrae optimization are calculated and compared.ResultsThe results showed that the calculated screw placements by the proposed method can achieve 88% success rate without breaking the pedicle cortex and 100% in clinical class A quality (allow less than 2 mm out of the pedicle cortex) compared to 86.1% and 99.1%, respectively, with the existing methods. Expert evaluation showed that the screw path trajectories and the connecting rod calculated by the new method satisfied the clinical implantation requirements.ConclusionsThe new screw planning approach that seeks an overall optimization for multi‐level vertebral fixation is feasible and more advantageous for clinical use than the single vertebral approaches.

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Minimally invasive transforaminal lumbar interbody fusion with unilateral pedicle screw fixation (UNILF): outcomes at 7 years

Hamel,

Prebet,

Lucas

et al. 2023

Eur Spine J

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Unilateral pedicle screw fixation of lumber spine: A safe internal fixation method

Cited by 4 publications

References 54 publications

Osteoid Osteomas of Spine: From Open to Minimally Invasive Excision of the Nidus – A Case series

Osteoid Osteomas of Spine: From Open to Minimally Invasive Excision of the Nidus – A Case series

Pedicle screw path planning for multi‐level vertebral fixation

Minimally invasive transforaminal lumbar interbody fusion with unilateral pedicle screw fixation (UNILF): outcomes at 7 years

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