Computed tomography-guided percutaneous facet screw fixation in the lumbar spine. Technical note.
The authors describe a new minimally invasive technique for posterior supplementation using percutaneous translaminar facet screw (TFS) fixation with computed tomography (CT) guidance. Oblique axial images were used to determine facet screw fixation sites. After the induction of local anesthesia and conscious sedation, a guide pin was inserted and guided with a laser mounted on the CT gantry. Cannulated TFSs were placed via a percutaneous approach. From December 2002 to August 2003, 18 patients underwent CT-guided TFS. In 17 of these patients this procedure was supplementary to anterior lumbar interbody fusion, which had been performed several days earlier; in the remaining patient, CT-guided TFS fixation was undertaken as the primary therapy. Twelve patients had painful degenerative disc disease or unstable degenerative spondylolisthesis, three had infections, and three had deformities. All screws were inserted accurately and there were no complications. This new minimally invasive surgical technique may offer an alternative to pedicle screw fixation as a method of posterior supplementation.
Kang
Ho Yeong
HY
Department of Radiology, Wooridul Spine Hospital, Seoul, Korea.
Lee
Sang-Ho
SH
Jeon
Sang Hyeop
SH
Shin
Song-Woo
SW
D001863:Bone Screws; D006801:Humans; D007403:Intervertebral Disc; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging* / Q000601:surgery*; D019060:Minimally Invasive Surgical Procedures; D012189:Retrospective Studies; D013122:Spinal Diseases / Q000601:surgery; D013123:Spinal Fusion; D013168:Spondylolisthesis / Q000601:surgery; D025321:Surgery, Computer-Assisted; D014057:Tomography, X-Ray Computed