Percutaneous posterior transdiscal oblique screw fixation with lateral interbody fusion: a radiological and cadaveric study.
OBJECTIVE
To design and investigate a novel technique of percutaneous posterior transdiscal oblique screw fixation with lateral interbody fusion.


METHODS
CT scans of 45 patients were collected and imported into Mimics software for three-dimensional (3D) reconstruction. Cylinders were drawn to simulate the trajectory of the oblique screw. Six measurements were obtained for each unit to design a right size cage: a the distance between the intersection of the simulated trajectory of the screw with the inferior border of the upper vertebra and its anteroinferior corner; b the distance between the intersection of the simulated trajectory of the screw with the superior border of the inferior vertebra and its anterosuperior corner; h the height of the intervertebral space; θ the angle between simulated trajectory of screw and the upper endplate of inferior vertebra; uw: the width of the inferior endplate of upper vertebra; iw: the width of upper endplate of inferior vertebra. Three intact adult fresh-frozen cadaveric specimens were obtained, percutaneous posterior transdiscal oblique screw fixation was performed under X-ray apparatus, and interbody cage was implanted by assistance with special self-retaining retractor system and endoscope.


RESULTS
According to the results of data measured from 3D images, trapezoid shape interbody cages with suitable size were designed. Percutaneous posterior oblique screw fixation with lateral interbody fusion was performed on three cadaveric specimens successfully.


CONCLUSIONS
Using specially designed trapezoid shape interbody cages, assisted by intra-operative image intensification and endoscope, it is feasible to perform percutaneous posterior transdiscal oblique screw fixation with lateral interbody fusion technique.
The Department of Spinal Surgery, Zhejiang Spinal Research Center, Second Affiliated Hospital of Wenzhou Medical University, 109# XueYuan Western Road, Wenzhou, 325027, Zhejiang, People's Republic of China, aiminwu@163.com.
Ai-Min
AM
Wu
Wen-Fei
WF
Ni
Zhen-Xuan
ZX
Shao
Xiang-Jie
XJ
Kong
Nai-Feng
NF
Tian
Yi-Xing
YX
Huang
Zhong-Ke
ZK
Lin
Hua-Zi
HZ
Xu
Yong-Long
YL
Chi
D000328:Adult; D001696:Biomechanical Phenomena; D001863:Bone Screws / Q000009:adverse effects*; D002102:Cadaver; D005260:Female; D006801:Humans; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging / Q000601:surgery*; D008297:Male; D013123:Spinal Fusion / Q000379:methods*; D014057:Tomography, X-Ray Computed