CORTICAL BONE TRAJECTORY VERSUS PEDICLE SCREW TECHNIQUES FOR DORSO-LUMBAR FIXATION

Document Type : Original Article

Authors

1 Department of Neurosurgery- Faculty of Medicine-Benha University

2 neurosurgery,medicine,benha,benha,egypt

3 Lecturer of neurosurgery, Benha University – Faculty of Medicine

4 Professor, Neurosurgery Dep., Banha Faculty of Medicine

Abstract

BACKGROUND: Posterior spine screw fixation to allow bony fusion is a common and reliable method of instrumentation of the spine for a variety of spine pathologies. The mainstay of this kind of surgery has been the use of pedicle screw fixation, traversing the pedicle down its anatomical axis with cancellous screw. The aim of this study to evaluate and compare the outcome of cortical bone trajectory technique to the pedicle screw technique in dorso-lumbar fixation.
PATIENTS AND METHODS: 40 patients with different lumbar pathologies were categorized into 2 groups (Group A) includes, 20 patients who operated with cortical bone trajectory technique (follow-up range 6-18months) and (Group B) includes, 20 patients operated with pedicle screw technique (follow up range 6-20months).
RESULTS: The mean VAS score improved significantly from 7.3 before surgery to 2.9 at the latest follow-up in group (A) and from 8 before surgery to 3.1 at the latest follow-up in group (B). The mean operative time was 130 minutes in group (A), and 140 in group (B). Solid bony fusion was achieved in18 patients (90%) in group (A) and in 17 patients (85%) in group (B), it does not differ regards the fusion rate with the pedicle screw.
CONCLUSIONS: Cortical bone trajectory takes advantage of a cortically based track through the pedicle, which may result in improved fixation strength compared with a traditionally placed pedicle screw in certain indications, the technique was initially advised for osteoporotic patients, Complications with this new technology have been low and excellent fusion rates.

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