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Minimally invasive one-level lumbar decompression and fusion surgery with posterior instrumentation using a combination of pedicle screw fixation and transpedicular facet screw construct.

Hsiang J, Yu K, He Y - Surg Neurol Int (2013)

Bottom Line: Two patients developed new leg pain on the side where the facet screw had been placed.Both patients had the facet screw removed.However, caution is needed during the placement of the percutaneous facet screw in order to avoid nerve root injury.

View Article: PubMed Central - PubMed

Affiliation: Swedish Neuroscience Institute, 550 17 Avenue, Suite 500, Seattle, WA 98122, USA.

ABSTRACT

Background: Minimally invasive lumbar spine fusion surgery has gained popularity in recent years. Routinely, this technique requires bilateral parasagittal incisions for decompression, interbody fusion, and posterior instrumentation. The following study is a description of a new minimally invasive technique for one-level transforaminal lumbar interbody fusion (TLIF) using a unilateral parasagittal incision (Wiltse approach), with placement of pedicle screws and then a percutaneous transpedicular facet screw insertion on the contralateral side. The biomechanical stability of this posterior construct will be discussed while the efficacy and complications of this technique have been examined.

Methods: Forty patients underwent this new technique of one-level TLIF with posterior instrumentation using unilateral pedicle screw fixation supplemented with contralateral percutaneous transpedicular facet screw construct. Data regarding surgical time, estimated blood loss (EBL), hospital length of stay (LOS), and complications related to the posterior instrumentation are recorded.

Results: The average surgical time of this new procedure was 124 minutes; average EBL was 140 cc; average hospital LOS was 3 days. Two patients developed new leg pain on the side where the facet screw had been placed. Both patients had the facet screw removed.

Conclusion: This novel technique of unilateral pedicle screw fixation combined with contralateral percutaneous transpedicular facet screw construct has further reduced the amount of normal tissue injury while maintaining the same biomechanical advantages of bilateral pedicle screw fixation. However, caution is needed during the placement of the percutaneous facet screw in order to avoid nerve root injury.

No MeSH data available.


Related in: MedlinePlus

Artist's drawing. Axial view to show the trajectory of the percutaneous facet screw
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Figure 4: Artist's drawing. Axial view to show the trajectory of the percutaneous facet screw


Minimally invasive one-level lumbar decompression and fusion surgery with posterior instrumentation using a combination of pedicle screw fixation and transpedicular facet screw construct.

Hsiang J, Yu K, He Y - Surg Neurol Int (2013)

Artist's drawing. Axial view to show the trajectory of the percutaneous facet screw
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3814991&req=5

Figure 4: Artist's drawing. Axial view to show the trajectory of the percutaneous facet screw
Bottom Line: Two patients developed new leg pain on the side where the facet screw had been placed.Both patients had the facet screw removed.However, caution is needed during the placement of the percutaneous facet screw in order to avoid nerve root injury.

View Article: PubMed Central - PubMed

Affiliation: Swedish Neuroscience Institute, 550 17 Avenue, Suite 500, Seattle, WA 98122, USA.

ABSTRACT

Background: Minimally invasive lumbar spine fusion surgery has gained popularity in recent years. Routinely, this technique requires bilateral parasagittal incisions for decompression, interbody fusion, and posterior instrumentation. The following study is a description of a new minimally invasive technique for one-level transforaminal lumbar interbody fusion (TLIF) using a unilateral parasagittal incision (Wiltse approach), with placement of pedicle screws and then a percutaneous transpedicular facet screw insertion on the contralateral side. The biomechanical stability of this posterior construct will be discussed while the efficacy and complications of this technique have been examined.

Methods: Forty patients underwent this new technique of one-level TLIF with posterior instrumentation using unilateral pedicle screw fixation supplemented with contralateral percutaneous transpedicular facet screw construct. Data regarding surgical time, estimated blood loss (EBL), hospital length of stay (LOS), and complications related to the posterior instrumentation are recorded.

Results: The average surgical time of this new procedure was 124 minutes; average EBL was 140 cc; average hospital LOS was 3 days. Two patients developed new leg pain on the side where the facet screw had been placed. Both patients had the facet screw removed.

Conclusion: This novel technique of unilateral pedicle screw fixation combined with contralateral percutaneous transpedicular facet screw construct has further reduced the amount of normal tissue injury while maintaining the same biomechanical advantages of bilateral pedicle screw fixation. However, caution is needed during the placement of the percutaneous facet screw in order to avoid nerve root injury.

No MeSH data available.


Related in: MedlinePlus