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Erschienen in: European Spine Journal 2/2018

16.04.2018 | Original Article

Cortical bone trajectory screws for circumferential arthrodesis in lumbar degenerative spine: clinical and radiological outcomes of 101 cases

verfasst von: Nicola Marengo, Pedro Berjano, Fabio Cofano, Marco Ajello, Francesco Zenga, Giulia Pilloni, Federica Penner, Salvatore Petrone, Lorenzo Vay, Alessandro Ducati, Diego Garbossa

Erschienen in: European Spine Journal | Sonderheft 2/2018

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Abstract

Purpose

The use of cortical bone trajectory (CBT) pedicle screws for circumferential interbody fusion represents a viable alternative for single-level procedure with reduced invasiveness and less tissue destruction than the traditional technique. In addition, CBT screws have a potentially stronger pullout strength because of the greater amount of cortical bone intercepted. Only few series exist evaluating clinical and radiological outcomes of CBT screws.

Methods

This is a retrospective cohort study. All patients that underwent circumferential lumbar interbody fusion with CBT screws in our institution from 2014 to 2017 were reviewed. Patient demographics, clinical outcome with visual analogue scale (VAS) and Oswestry Disability Index (ODI), radiological data such as fusion, lordosis and muscle trauma, operative blood loss, hospital stay and use of fluoroscopy were evaluated.

Results

A total of 101 patients undergoing CBT-arthrodesis for degenerative lumbo-sacral disease were reviewed. Mean procedural time was 187 min. The mean operative blood loss and X-ray dose per procedure was 383 ml and 1.60 mg cm2, respectively. The mean hospital stay was 3.47 days. The mean follow-up was 18.23 months. Mean lordosis increment at the treated level was 4.2°. When the follow-up was longer than 12 months (53% of patients), fusion was obtained in 94% of cases. Mean ODI and VAS index improved with statistical significance.

Conclusions

This is to our knowledge that the largest available study regarding CBT for circumferential arthrodesis. Results underlined the safety of this technique and the promising clinical and radiological outcomes that will need a longer follow-up.

Graphical abstract

These slides can be retrieved under Electronic Supplementary material.
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Literatur
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Zurück zum Zitat Sakaura H, Miwa T, Yamashita T et al (2017) Cortical bone trajectory screw fixation versus traditional pedicle screw fixation for 2-level posterior lumbar interbody fusion: comparison of surgical outcomes for 2-level degenerative lumbar spondylolisthesis. J Neurosurg Spine 1–6. https://doi.org/10.3171/2017.5.spine161154 Sakaura H, Miwa T, Yamashita T et al (2017) Cortical bone trajectory screw fixation versus traditional pedicle screw fixation for 2-level posterior lumbar interbody fusion: comparison of surgical outcomes for 2-level degenerative lumbar spondylolisthesis. J Neurosurg Spine 1–6. https://​doi.​org/​10.​3171/​2017.​5.​spine161154
Metadaten
Titel
Cortical bone trajectory screws for circumferential arthrodesis in lumbar degenerative spine: clinical and radiological outcomes of 101 cases
verfasst von
Nicola Marengo
Pedro Berjano
Fabio Cofano
Marco Ajello
Francesco Zenga
Giulia Pilloni
Federica Penner
Salvatore Petrone
Lorenzo Vay
Alessandro Ducati
Diego Garbossa
Publikationsdatum
16.04.2018
Verlag
Springer Berlin Heidelberg
Erschienen in
European Spine Journal / Ausgabe Sonderheft 2/2018
Print ISSN: 0940-6719
Elektronische ISSN: 1432-0932
DOI
https://doi.org/10.1007/s00586-018-5599-8

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