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Lumbar pedicle cortical bone trajectory screw.

Tengfei Song1, Wellington K Hsu2, Tianwen Ye3

  • 1Department of Orthopaedic Surgery, Shanghai Changzheng Hospital, Second Military Medical University, Shanghai 200003, China.

Chinese Medical Journal
|November 11, 2014
PubMed
Summary

The cortical bone trajectory (CBT) screw fixation technique offers a novel approach to lumbar pedicle surgery. This minimally invasive method provides enhanced stability and safety, particularly for patients with osteoporosis and obesity.

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Area of Science:

  • Spine Surgery
  • Orthopedic Biomechanics
  • Minimally Invasive Techniques

Background:

  • Traditional pedicle screw fixation in lumbar surgery presents challenges.
  • The need for improved fixation methods, especially in compromised bone quality.

Purpose of the Study:

  • To demonstrate the lumbar pedicle cortical bone trajectory (CBT) screw fixation technique.
  • To review the concepts, morphometrics, biomechanics, and clinical applications of CBT.

Main Methods:

  • Systematic review of PubMed-published articles from 1994-2014.
  • Selection of original articles and critical reviews on CBT and lumbar pedicle fixation.

Main Results:

  • CBT screw insertion is lateral to the pars interarticularis, with a caudocephalad and lateral trajectory.
  • This technique offers superior biomechanical stability, fixation strength, and surgical safety.
  • CBT is beneficial for posterior fixation in lumbar fusion, especially for osteoporotic and obese patients.

Conclusions:

  • Cortical bone trajectory (CBT) screw fixation is a superior alternative for lumbar pedicle fixation.
  • The technique is particularly advantageous for patients with osteoporosis and obesity, enhancing surgical outcomes.