scholarly journals Efficacy of pedicle screw fixation in the treatment of spinal instability and failed back surgery: a 5-year review

1998 ◽  
Vol 5 (1) ◽  
pp. E1
Author(s):  
Roberto Masferrer ◽  
Carlos H. Gomez ◽  
Dean G. Karahalios ◽  
Volker K. H. Sonntag
Keyword(s):  
Back Pain ◽  
Lumbar Spine ◽  
Pedicle Screw ◽  
Screw Fixation ◽  
Pedicle Screw Fixation ◽  
Current Status ◽  
Safe Procedure ◽  
Hospital System ◽  
Failed Back Surgery ◽  
Osseous Union

Object The goal of this study was to review retrospectively the outcome of 95 patients with various disorders leading to instability of the thoracolumbar and lumbar spine who were treated consecutively via a posterior surgical approach with pedicle screw fixation in which the Texas Scottish Rite Hospital system was used. Methods All cases were managed according to the same protocol. Follow-up review averaged 29.6 months. Radiographic evidence of osseous union and the patient's current status were analyzed. Four screws were malpositioned, and there were two dural lacerations of a nerve root and one pedicle fracture. Deep wound infections developed in five patients (5.2%) and three patients had postoperative radicular pain. In one case, the rods disengaged from the screws; in four cases, hardware was removed but there were no broken screws. Neurological deficits improved in 85% of the patients and no patient was worse neurologically after surgery. The rate of osseous union was 96.8%. Three patients developed pseudarthrosis, one of whom was asymptomatic. Back pain improved in 80 patients (85%). A solid bone fusion, however, was not necessarily associated with decreased back pain. Conclusions These results support the use of pedicle screw fixation as an effective and safe procedure for fusion of the thoracolumbar and lumbar spine and support the finding that complications can be minimal when a meticulous surgical technique is used. The proper selection of patients for surgery is probably the most important factor associated with good outcomes.

Efficacy of pedicle screw fixation in the treatment of spinal instability and failed back surgery: a 5-year review

1998 ◽  
Vol 89 (3) ◽  
pp. 371-377 ◽  
Author(s):  
Roberto Masferrer ◽  
Carlos H. Gomez ◽  
Dean G. Karahalios ◽  
Volker K. H. Sonntag
Keyword(s):  
Back Pain ◽  
Lumbar Spine ◽  
Pedicle Screw ◽  
Screw Fixation ◽  
Pedicle Screw Fixation ◽  
Safe Procedure ◽  
Content Type ◽  
Failed Back Surgery ◽  
Osseous Union ◽  
Fine Print

Object. The goal of this study was to review retrospectively the outcome of 95 patients with various disorders leading to instability of the thoracolumbar and lumbar spine who were treated consecutively via a posterior surgical approach with pedicle screw fixation in which the Texas Scottish Rite Hospital system was used. Methods. All cases were managed according to the same protocol. Follow-up review averaged 29.6 months. Radiographic evidence of osseous union and the patient's current status were analyzed. Four screws were malpositioned, and there were two dural lacerations of a nerve root and one pedicle fracture. Deep wound infections developed in five patients (5.2%), and three patients had postoperative radicular pain. In one case, the rods disengaged from the screws; in four cases, hardware was removed but there were no broken screws. Neurological deficits improved in 85% of the surviving patients, and no patient was worse neurologically after surgery. The rate of osseous union was 96.8%. Three patients developed pseudarthrosis, one of whom was asymptomatic. Back pain improved in 80 patients. A solid bone fusion, however, was not necessarily associated with decreased back pain. Conclusions. These results support the use of pedicle screw fixation as an effective and safe procedure for fusion of the thoracolumbar and lumbar spine and support the finding that complications can be minimal when a meticulous surgical technique is used. The proper selection of patients for surgery is probably the most important factor associated with good outcomes.

scholarly journals Guideline update for the performance of fusion procedures for degenerative disease of the lumbar spine. Part 12: Pedicle screw fixation as an adjunct to posterolateral fusion

2014 ◽  
Vol 21 (1) ◽  
pp. 75-78 ◽  
Author(s):  
Michael W. Groff ◽  
Andrew T. Dailey ◽  
Zoher Ghogawala ◽  
Daniel K. Resnick ◽  
William C. Watters ◽  
...  
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Clinical Outcome ◽  
Pedicle Screw ◽  
Chronic Low Back Pain ◽  
Screw Fixation ◽  
Lumbar Fusion ◽  
Pedicle Screw Fixation ◽  
Controlled Study ◽  
Low Back

The utilization of pedicle screw fixation as an adjunct to posterolateral lumbar fusion (PLF) has become routine, but demonstration of a definitive benefit remains problematic. The medical evidence indicates that the addition of pedicle screw fixation to PLF increases fusion rates when assessed with dynamic radiographs. More recent evidence, since publication of the 2005 Lumbar Fusion Guidelines, suggests a stronger association between radiographic fusion and clinical outcome, although, even now, no clear correlation has been demonstrated. Although several reports suggest that clinical outcomes are improved with the addition of pedicle screw fixation, there are conflicting findings from similarly classified evidence. Furthermore, the largest contemporary, randomized, controlled study on this topic failed to demonstrate a significant clinical benefit with the use of pedicle screw fixation in patients undergoing PLF for chronic low-back pain. This absence of proof should not, however, be interpreted as proof of absence. Several limitations continue to compromise these investigations. For example, in the majority of studies the sample size is insufficient to detect small increments in clinical outcome that may be observed with pedicle screw fixation. Therefore, no definitive statement regarding the efficacy of pedicle screw fixation as a means to improve functional outcomes in patients undergoing PLF for chronic low-back pain can be made. There appears to be consistent evidence suggesting that pedicle screw fixation increases the costs and complication rate of PLF. High-risk patients, including (but not limited to) patients who smoke, patients who are undergoing revision surgery, or patients who suffer from medical conditions that may compromise fusion potential, may appreciate a greater benefit with supplemental pedicle screw fixation. It is recommended, therefore, that the use of pedicle screw fixation as a supplement to PLF be reserved for those patients in whom there is an increased risk of nonunion when treated with only PLF.

CE FEATURE: Part 2: Pedicle Screw Fixation in the Lumbar Spine

1990 ◽  
Vol 9 (6) ◽  
pp. 22-32
Author(s):  
Hannah Brosnan ◽  
Pam Berda
Keyword(s):  
Lumbar Spine ◽  
Pedicle Screw ◽  
Screw Fixation ◽  
Pedicle Screw Fixation

scholarly journals Wire Fixation compared with Pedicle Screw Fixation for Unstable Lumbar Spine.

1998 ◽  
Vol 47 (1) ◽  
pp. 70-75
Author(s):  
Hiroki Imoto ◽  
Kensei Nagata ◽  
Mamoru Ariyoshi ◽  
Kazumasa Ishibashi ◽  
Kyosuke Sonoda ◽  
...  
Keyword(s):  
Lumbar Spine ◽  
Pedicle Screw ◽  
Screw Fixation ◽  
Pedicle Screw Fixation ◽  
Wire Fixation

Pedicle-Screw Fixation in the Lumbar Spine

1995 ◽  
Vol 3 (5) ◽  
pp. 263-274 ◽  
Author(s):  
Alexander R. Vaccaro ◽  
Steven R. Garfin
Keyword(s):  
Lumbar Spine ◽  
Pedicle Screw ◽  
Screw Fixation ◽  
Pedicle Screw Fixation

Internal Fixation (Pedicle Screw Fixation) for Fusions of the Lumbar Spine

Spine ◽  
1995 ◽  
Vol 20 ◽  
pp. 166S ◽  
Author(s):  
Alexander R. Vaccaro ◽  
Steven R. Garfin
Keyword(s):  
Lumbar Spine ◽  
Internal Fixation ◽  
Pedicle Screw ◽  
Screw Fixation ◽  
Pedicle Screw Fixation
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