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Related Experiment Video

Updated: Jun 19, 2026

Minimally Invasive Treatment for Thoracolumbar Burst Fracture Using Sagittal Alignment Screws and A Trauma Reduction Device
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Transsacral screw fixation for high-grade spondylolisthesis.

Palaniappan Lakshmanan1, Sashin Ahuja, Mark Lewis

  • 1University Hospital of Wales, Cardiff, United Kingdom. lakunns@gmail.com

The Spine Journal : Official Journal of the North American Spine Society
|October 13, 2009
PubMed
Summary

This study shows that circumferential fusion using transsacral hollow modular anchorage (HMA) screws and pedicle fixation effectively treats high-grade spondylolisthesis. The technique resulted in successful fusion, pain relief, and improved function in patients.

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Area of Science:

  • Spine surgery
  • Orthopedics
  • Surgical techniques

Background:

  • Symptomatic high-grade spondylolisthesis (Meyerding III-V) typically requires surgical intervention.
  • In situ fusion is favored over reduction and fusion for high-grade spondylolisthesis.
  • Circumferential fusion offers improved outcomes in severe cases.

Purpose of the Study:

  • To evaluate the efficacy of circumferential fusion using transsacral hollow modular anchorage (HMA) screws combined with pedicle screw fixation and posterolateral fusion.
  • To analyze patient outcomes, including pain reduction and functional improvement.

Main Methods:

  • Retrospective review of 12 patients with high-grade spondylolisthesis.
  • Interbody fusion performed using transsacral HMA screws filled with bone graft.

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Last Updated: Jun 19, 2026

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  • Supplementation with pedicle screw instrumentation and posterolateral fusion.

    • Main Results:

    • Eleven of 12 patients experienced resolution of leg pain.
    • No neurological complications were reported.
    • Significant improvements in SF-36 physical function (p=.001) and pain scores (p=.001) were observed at a mean follow-up of 21 months.

    Conclusions:

    • Transsacral HMA screws provide a viable alternative to autologous grafts, promoting interbody fusion.
    • Combined HMA and pedicle screw fixation create a stable construct for circumferential fusion.
    • This technique effectively achieves fusion and improves outcomes in high-grade spondylolisthesis.