Minimization of the number of pedicular screws placing in the degenerative lumbar spine.
OBJECTIVE
The present study was carried out to compare clinical results of spinal fusion in degenerative disease of lumbar between using pedicular screw instrumentation in every pedicle and partial placing the screws in some vertebra to provide immediate stabilization of the spine.


METHODS
Fifty patients with degenerative diseases of their lumbar spines and needing spinal fusion between 2004 and 2007 were included in this study. They were divided into two groups by the order of their admissions. All underwent complete decompressive laminectomy and posterlateral fusion with autogenic bone grafting. In the first group, 25 patients received pedicular screw instrumentation at all pedicles that were in the fusion area. In the second group, 25 patients received pedicular screw instrumentation only in particular pedicles to minimize the operative time, blood loss and the cost of instrumentation. Japanese Orthopedic Association (JOA) Lumbar Scoring System was used to evaluate function outcome of the patients.


RESULTS
There was no serious complication in both groups. Furthermore, there was no significant difference in terms of operative time, amount of blood loss, time to bone union, and JOA lumbar score at the one-year follow-up between the groups. However, the costs of instrumentation were significantly reduced in the second group.


CONCLUSIONS
Minimizing the numbers of pedicular screws instrumentation for spinal fusion of degenerative spine could be carried out to lessen the cost of treatment in particular patients.
Hirunyachote
Pinit
P
Department of Orthopaedic Surgery, Nakhonpathom Hospital, Nakhonpathom, Thailand.
Adukasem
Wallop
W
D001863:Bone Screws; D005260:Female; D006305:Health Status Indicators; D006801:Humans; D007405:Intervertebral Disc Displacement / Q000175:diagnosis / Q000473:pathology / Q000601:surgery*; D008159:Lumbar Vertebrae / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D019636:Neurodegenerative Diseases / Q000175:diagnosis / Q000473:pathology / Q000601:surgery*; D013123:Spinal Fusion / Q000295:instrumentation / Q000379:methods*; D016896:Treatment Outcome