Midline lumbar fusion with cortical bone trajectory screw

Area of Science:

• Orthopedic Surgery
• Spinal Fusion Techniques
• Minimally Invasive Spine Surgery

Background:

• Traditional lumbar fusion approaches can involve significant tissue disruption.
• Cortical bone trajectory (CBT) screws offer theoretical advantages in screw grip and fixation strength.
• Lumbar spondylolisthesis requires effective and minimally invasive surgical solutions.

Purpose of the Study:

• To evaluate the clinical and radiological outcomes of the midline lumbar fusion (MIDLF) technique utilizing CBT screws for lumbar spondylolisthesis.
• To determine if MIDLF with CBT screw fixation is as effective as traditional methods while being minimally invasive.

Main Methods:

• The study involved adopting the MIDLF technique, which includes a posterior midline approach, microsurgical laminectomy, and CBT screw fixation.
• Clinical and radiological outcomes were assessed in patients with lumbar spondylolisthesis.
• The trajectory of CBT screws engages the pedicle's cortical bone, creating specific paths in sagittal and axial planes.

Main Results:

• MIDLF with CBT screw fixation proved to be an effective and minimally invasive technique for lumbar spondylolisthesis.
• Patients exhibited good recovery scores, indicating positive clinical outcomes.
• Radiological assessment confirmed the safety and stability of the CBT screw technique.

Conclusions:

• MIDLF combined with CBT screw fixation is a safe, effective, and minimally invasive surgical option for lumbar spondylolisthesis.
• This technique offers surgeons an additional fixation choice, particularly beneficial when combined with midline decompression and interbody grafting.
• The findings support MIDLF with CBT screws as a viable alternative for treating lumbar spondylolisthesis.