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Minimally Invasive Treatment for Thoracolumbar Burst Fracture Using Sagittal Alignment Screws and A Trauma Reduction Device
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Strategy for salvage pedicle screw placement: A technical note.

Shunsuke Fujibayashi1, Mitsuru Takemoto1, Masashi Neo2

  • 1Department of Orthopaedic Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan.

International Journal of Spine Surgery
|February 20, 2015
PubMed
Summary

Salvage surgery for failed lumbar spine fusion can be improved with the new different trajectory (DT) pedicle screw replacement technique. This method successfully achieved bony union and avoided fusion extension in patients.

Keywords:
Pedicle screwSalvage surgerySpinal fixation

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Area of Science:

  • Spine surgery
  • Orthopedic surgery
  • Neurosurgery

Background:

  • Salvage surgery for failed lumbar spine fusion with loosened pedicle screws presents significant challenges.
  • Current strategies include using larger screws, cement augmentation, or extending fused segments.

Purpose of the Study:

  • To introduce and evaluate a novel different trajectory (DT) pedicle screw replacement technique for salvage lumbar spine surgery.

Main Methods:

  • Five salvage operations utilized the DT pedicle screw replacement technique guided by 3D radiological information and a navigation system.
  • Preoperative planning determined screw placement, with two techniques chosen for initial stability: a new route or penetration of the existing screw hole.

Main Results:

  • The DT pedicle screws were successfully placed as planned in all cases.
  • All patients achieved bony union without instrument failure at final follow-up.
  • The DT technique, combined with transforaminal lumbar interbody fusion, successfully avoided the need for extended fusion segments.

Conclusions:

  • The DT pedicle screw replacement technique offers a viable option for salvage lumbar spine surgery.
  • This technique facilitates successful bony union and avoids fusion extension.