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Expanded Indications for Hybrid Spinal Fixation Systems; Combined Percutaneous Pedicle Screw Fixation and Open
Thomas Repantis1, Ioanna Lianou1, Ioannis Papaioannou1
1Orthopedic Department, General Hospital of Patras, 26224 Patras, Greece.
Journal of Personalized Medicine
|July 27, 2026
Summary
Hybrid minimally invasive spinal surgery combines percutaneous pedicle screw fixation (PPSF) with open or mini-open techniques. These hybrid approaches offer improved patient recovery by reducing trauma and morbidity for complex spinal disorders.
Area of Science:
- Spine Surgery
- Minimally Invasive Techniques
- Spinal Instrumentation
Background:
- Percutaneous pedicle screw fixation (PPSF) initially treated degenerative spinal deformities.
- Indications for PPSF have expanded to various spinal pathologies.
- Minimally invasive spinal surgery offers lower morbidity than open procedures.
Purpose of the Study:
- Review recent literature on hybrid minimally invasive spinal instrumentation.
- Focus on combined PPSF with open/mini-open approaches.
- Evaluate roles in personalized surgical management.
Main Methods:
- Conducted literature search in PubMed and Web of Science.
- Identified studies on expanded PPSF indications and novel techniques.
- Categorized 35 studies by pathology.
Main Results:
- Most studies were retrospective (Oxford CEBM Levels III-IV).
- Included a smaller number of prospective studies and systematic reviews.
- Hybrid methods demonstrated effectiveness in managing complex spinal disorders.
Conclusions:
- Hybrid minimally invasive spinal surgery is expanding for complex spinal disorders.
- These techniques provide stability, enable decompression/correction, and minimize trauma.
- Moderate evidence supports patient-specific, pathology-driven strategies for optimal outcomes.
