Surgical Experience of Transpedicular Screw Fixation of the Lumbar Spine

ABSTRACT

Transpedicular screw fixation of the lumbar spine has evolved rapidly and become one of the reliable methods to application. We treated 42 cases of lumbar spine disease using above method from October, 1987, to Febuary, 1993. The disease entities were spondylolisthesis 24 cases(58%), spondylolysis 14 cases(33%), fracture and dislocation 3 cases(7%), postsurgical instability 1 case(2%). The most frequent clinical symptom and sign was low back pain with radiating pain accompanying limitation of straight leg raising, which clinical outcome was excellent with wide laminectomy. The transpedicular screw fixation allow adequate neural decompression, short segment fixation and prevention of motion limitation of lumbar spine. But one of the important complication driven with this method was root injury which must be prevented by surgen's throught knowledge to pedicular anatomy and meticulous operative technique. The instrument failure is also the troublesome problem. The appropriate bone fusion will be the acceptable strategy to overcome the eventual possibility of instument failure.