Interested medical professionals can read the full paper, as published in Clinical Biomechanics, here.
The use of pedicle screws is the gold standard for supplemental posterior fixation in lateral interbody fusion. Information about the performance of transfacet pedicle screws compared to standard pedicle screws and rods in the upper lumbar spine with or without a lateral interbody fusion device in place is limited.
Fifteen fresh frozen human cadaveric lumbar spine segments (T12-L4) were studied using standard pure moment flexibility tests. Specimens were divided into two groups to receive either bilateral transfacet pedicle screws (n=8) or bilateral pedicle screws (n=14). Stability of each motion segment (L1-L2 and L2-L3) was evaluated intact, with posterior instrumentation with an intact disc, with posterior instrumentation and a lateral interbody fusion device in place, and following cyclic loading with the interbody device and posterior instrumentation still in place. Both raw values of motion (range of motion, lax zone and stiff zone) and normalized mobility (ratios to intact) were analyzed for each case.
In terms of immediate stability, transfacet pedicle screws performed equivalent to similarly sized pedicle screws, both with intact disc and with lateral interbody fusion device in all directions of loading. Stability following cyclic loading decreased significantly during lateral bending and axial rotation.
Posterior fixation with transfacet pedicle screws provides equivalent immediate stability to similarly sized pedicle screws. However, in the presence of a lateral interbody fusion device, pedicle screws seem to resist loosening more and may be a better option for fusion in the upper lumbar spine.
About Author Dr. Kingsley R. Chin
Dr. Kingsley R. Chin is a board-certified Harvard-trained Orthopedic Spine Surgeon and Professor with copious business and information technology exposure. He sees a niche opportunity where medicine, business and info. tech meet – and is uniquely educated at the intersection of these three professions. He has experience as Professor of Clinical Biomedical Sciences & Admissions Committee Member at the Charles E. Schmidt College of Medicine at Florida Atlantic University, Professor of Clinical Orthopedic Surgery at the Herbert Wertheim College of Medicine at Florida International University, Assistant Professor of Orthopaedics at the University of Pennsylvania Medical School, Visiting Spine Surgeon & Professor at the University of the West Indies, Mona, and Adjunct Professor of Clinical Biomedical Sciences at the University of Technology, Jamaica.
About Less Exposure Surgery
Less Exposure Surgery (LES) is based on a new philosophy of performing surgery, leading the charge to prove through bench and clinical outcomes research that LES treatment options are the best solutions – to lowering the cost of healthcare, improving outcomes and increasing patient satisfaction. Learn more at LESSociety.org.
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The above study utilized LES Technology from SpineFrontier – leading provider of LES Technologies and instruments – offering surgeons and patients superior technology and services.
Scientific Paper Author & Citation Details
Department of Clinical Biomedical Sciences, Charles E. Schmidt College of Medicine at Florida Atlantic University, Boca Raton, Fort Lauderdale, FL, USA; Less Exposure Surgery Specialists Institute (LESS Institute), Fort Lauderdale, FL, USA. Electronic address: Kingsleychin@gmail.com.
Barrow Neurological Institute, St. Joseph’s Hospital and Medical Center, Phoenix, AZ, USA.
Less Exposure Surgery Specialists Institute (LESS Institute), Fort Lauderdale, FL, USA.