title: Emerging Techniques for Posterior Fixation of the Lumbar Spine.
abstract: Pedicle screw fixation is the preferred method of posterior fusion in lumbar spinal surgery. The technique provides three-column support of the vertebrae, contributing to the biomechanical strength of the construct. However, open pedicle screw fixation often necessitates wide posterior exposure and dissection with soft-tissue disruption of the facet joint. Alternative posterior fixation techniques have been developed to reduce surgical time, soft-tissue dissection, disruption of the adjacent facet joint capsule, neurologic risk, and implant cost. Results of these techniques are comparable to those of standard pedicle screw fixation systems. Certain patients, especially those at a lower risk of nonunion or those who require posterior fixation only as an adjunct to anterior column support, may benefit from the shorter surgical time and limited posterior exposure of the alternative techniques. However, the decreased rigidity of these alternative constructs can result in excessive motion, which can lead to nonunion and early hardware failure.
authors.affiliation: From the Department of Orthopaedic Surgery, University of California, San Francisco, CA (Dr. Verma), the Department of Orthopaedic Surgery, Drexel University College of Medicine, Philadelphia, PA (Dr. Boniello), and the Rothman Institute, Thomas Jefferson University Hospital, Philadelphia, PA (Dr. Rhin).
authors.forename: Kushagra
authors.initials: K
authors.lastname: Verma
authors.forename: Anthony
authors.initials: A
authors.lastname: Boniello
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Rihn
mesh_terms: D001863:Bone Screws; D006801:Humans; D016268:Internal Fixators; D008159:Lumbar Vertebrae / Q000601:surgery*; D061646:Operative Time; D013123:Spinal Fusion / Q000295:instrumentation / Q000379:methods*; D016896:Treatment Outcome