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Midline lumbar fusion using cortical bone trajectory screws. Preliminary report
Mateusz Bielecki1, Przemysław Kunert1, Marek Prokopienko1
1Department of Neurosurgery, Medical University of Warsaw, Warsaw, Poland.
Summary
Midline lumbar fusion (MIDLF) using cortical bone trajectory offers a less invasive spinal fusion option. This preliminary study shows promising results for degenerative lumbar disease, with symptom improvement and no complications in five patients.
Area of Science:
- Spine surgery
- Orthopedic surgery
- Minimally invasive spine surgery
Background:
- Midline lumbar fusion (MIDLF) with cortical bone trajectory presents an alternative to traditional transpedicular spinal fusion for degenerative disc disease.
- This technique may reduce approach-related morbidity due to modified entry points and screw trajectory.
Purpose of the Study:
- To evaluate the initial clinical outcomes and safety of the MIDLF technique.
- To assess the MIDLF technique in five patients with lumbar degenerative disease.
Main Methods:
- Retrospective analysis of five patients undergoing MIDLF for lumbar stenosis (4 foraminal, 1 central).
- Fusion levels included L4-L5 (3 patients) and L5-S1 (2 patients).
- Minimum follow-up of six months.
Main Results:
- All patients experienced symptom relief, including sciatica and claudication.
- Significant improvements were observed in Visual Analogue Scale (VAS) for low back pain (2.2) and leg pain (4.8).
- Oswestry Disability Index (ODI) improved from 52% to 33% at 3-month follow-up. Radiographic assessment showed satisfactory screw placement in all cases.
Conclusions:
- The MIDLF technique shows potential as an alternative for short-segment lumbar fusion.
- Further long-term studies with larger patient cohorts are necessary to confirm safety and durability.
