Abstract
Background: The cortical bone trajectory (CBT) technique is a popular minimally invasive spine surgery. Few studies have reported long-term outcomes. Here, we evaluated the complication profile and long-term follow-up of patients with lumbar degenerative disease treated with the CBT technique. Methods: This retrospective analysis included the first 40 consecutive patients that underwent the CBT technique. The indication for surgery was critical stenosis of the intervertebral foramen, which required removal of the entire intervertebral joint, on at least one side, during decompression. Results: The CBT technique was performed on one spine level, in 29 cases, and on two levels, in 11 cases. The last follow-up showed minimal clinically important differences in the numerical rating scale (NRS) of leg pain, the NRS of back pain, and the Oswestry Disability Index (ODI), in 97%, 95%, and 95% of patients, respectively. Thirty-nine patients completed long-term radiological follow-ups. Computed tomography demonstrated solid bone unions on 47 (92%) operated levels, collapsed unions on 2 (4%) levels, non-union on 1 (2%) level, and 1 (2%) lost to follow-up. Seven patients experienced complications (4 hardware-related). Three patients required four revision surgeries.Conclusions: The CBT technique effectively achieved spinal fusion; over 90% of patients achieved clinical improvement at a mean follow-up of 4.4 years (minimum 3 years in all cases).