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Cortical bone trajectory screws fixation in lumbar adjacent segment disease: A technique note with case series
Chao-Hsuan Chen1, Hsieng-Ming Huang1, Der-Cherng Chen1
1Department of Neurosurgery, China Medical University Hospital, Taichung, Taiwan, ROC.
Summary
This study introduces a minimally invasive technique using cortical bone trajectory screws for lumbar adjacent segment disease, avoiding previous instrument removal. This approach reduced complications and improved patient outcomes in six cases.
Area of Science:
- Spine Surgery
- Orthopedics
- Minimally Invasive Procedures
Background:
- Lumbar adjacent segment disease frequently necessitates revision surgery.
- Traditional revision surgery often requires removal of prior instrumentation, increasing risks.
- Complications include pain, fibrosis, poor wound healing, and infection.
Purpose of the Study:
- To evaluate a novel minimally invasive technique for lumbar adjacent segment disease.
- To assess the efficacy of cortical bone trajectory screws and inter-body cage fusion without prior hardware removal.
- To present surgical details for a potentially improved treatment option.
Main Methods:
- Six patients with lumbar adjacent segment disease were treated between October 2015 and March 2016.
- The technique involved cortical bone trajectory screws fixation with minimally invasive inter-body cage fusion.
- Pre-existing instruments were not removed.
Main Results:
- All six patients demonstrated improvement post-surgery.
- No recurrence of disease or instrument failure was observed during follow-up.
- The technique minimized wound length, blood loss, and soft tissue damage compared to traditional methods.
Conclusions:
- Minimally invasive cortical bone trajectory screw fixation with inter-body cage fusion is a viable option for lumbar adjacent segment disease.
- This technique avoids the need for prior instrument removal, reducing surgical morbidity.
- The approach offers potential benefits for spine surgeons managing complex revision cases.
