Percutaneous pedicle screw fixation of the lumbar spine.

Kevin Foley, S. K. Gupta, J. R. Justis, M. C. Sherman

Research output: Contribution to journalArticle

113 Citations (Scopus)

Abstract

OBJECT: Standard techniques for lumbar pedicle screw fixation involve open exposures and extensive muscle dissection. The purpose of this study was to report the initial clinical experience with a novel device for percutaneous posterior fixation of the lumbar spine. METHODS: An existing multiaxial lumbar pedicle screw system was modified so that screws could be placed percutaneously by using an extension sleeve that would allow for remote manipulation of the polyaxial screw heads and remote engagement of the screw locking mechanism. A unique rod insertion device was developed that linked to the screw extension sleeves, allowing for a precut, precontoured rod to be placed through a small stab wound. Because the insertion device relies on geometrical constraint of the rod pathway through the screw heads, rods can be placed in a standard submuscular position with minimal manipulation, essentially no muscle dissection, and without the need for direct visual feedback. Twelve patients (six men and six women who ranged in age from 23-68 years) underwent pedicle screw fixation in which the rod insertion device was used. Spondylolisthesis was present in 10 patients and nonunion of a prior interbody fusion was present in two. All patients underwent successful percutaneous fixation. Ten patients underwent single-level fusions (six at L5-S1, three at L4-5, and one at L2-3), and two underwent two-level fusions (one from L-3 to L-5 and the other from L-4 to S-1). The follow-up period ranged from 3 to 12 months (mean 6.8 months). CONCLUSIONS: Although percutaneous lumbar pedicle screw placement has been described previously, longitudinal connector (rod or plate) insertion has been more problematic. The device used in this study allows for straightforward placement of lumbar pedicle screws and rods through percutaneous stab wounds. Paraspinous tissue trauma is minimized without compromising the quality of spinal fixation. Preliminary experience with this device has been promising.

Original languageEnglish (US)
JournalNeurosurgical Focus
Volume10
Issue number4
StatePublished - Jan 1 2001

Fingerprint

Spine
Equipment and Supplies
Stab Wounds
Dissection
Head
Spondylolisthesis
Muscles
Sensory Feedback
Pedicle Screws
Wounds and Injuries

All Science Journal Classification (ASJC) codes

  • Surgery
  • Clinical Neurology

Cite this

Foley, K., Gupta, S. K., Justis, J. R., & Sherman, M. C. (2001). Percutaneous pedicle screw fixation of the lumbar spine. Neurosurgical Focus, 10(4).

Percutaneous pedicle screw fixation of the lumbar spine. / Foley, Kevin; Gupta, S. K.; Justis, J. R.; Sherman, M. C.

In: Neurosurgical Focus, Vol. 10, No. 4, 01.01.2001.

Research output: Contribution to journalArticle

Foley, K, Gupta, SK, Justis, JR & Sherman, MC 2001, 'Percutaneous pedicle screw fixation of the lumbar spine.', Neurosurgical Focus, vol. 10, no. 4.
Foley K, Gupta SK, Justis JR, Sherman MC. Percutaneous pedicle screw fixation of the lumbar spine. Neurosurgical Focus. 2001 Jan 1;10(4).
Foley, Kevin ; Gupta, S. K. ; Justis, J. R. ; Sherman, M. C. / Percutaneous pedicle screw fixation of the lumbar spine. In: Neurosurgical Focus. 2001 ; Vol. 10, No. 4.
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