Cortical bone trajectory technique’s outcomes and procedures for posterior lumbar fusion: A retrospective study |
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| Institution: | 1. Departamento de Neurocirugía, FLENI, Buenos Aires, Argentina;2. LINT, Facultad de Medicina, Universidad Nacional de Tucumán, Argentina;3. Departamento de Neurocirugía, Hospital Padilla, Tucumán, Argentina;1. Department of Internal Medicine, Soonchunhyang University Gumi Hospital, Gumi, South Korea;2. Cardiovascular Center, Korea University Guro Hospital, Seoul, South Korea;3. Department of Medicine, Korea University Graduate School, Seoul, South Korea;4. Cardiovascular Center, Soonchunhyang University Cheonan Hospital, Cheonan, South Korea;5. Department of Medicine, Konkuk University Chungju Hospital, Chungju, South Korea;6. Hospital of Kunming Medical University, Kuming, China;7. Department of Nursing, College of Medicine, Soonchunhyang University, Asan, South Korea;1. Service de Chirurgie Orthopédique et Réparatrice de l’Enfant, Hôpital Armand-Trousseau, Sorbonne Université, 26, Avenue du Dr Arnold-Netter, 75012 Paris, France;2. Service de Chirurgie Orthopédique Pédiatrique, Hôpital des Enfants Purpan, Université de Toulouse, Toulouse, France;3. Département des Maladies Musculo-Squelettiques et Innovations Thérapeutiques, Sorbonne Université, Paris, France |
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| Abstract: | Cortical Bone Trajectory screws allow a limited soft tissue dissection with mechanical properties comparable to traditional pedicle screws. However, clinical results are still reported on limited samples.The study aimed to evaluate perioperative and mid-term follow up outcomes, clinical results and complications in 238 consecutive patients underwent CBT fusion for degenerative lumbosacral disease.Pre- and intraoperative data, clinical outcomes and complications were collected. The patients were stratified in three groups. The original technique was performed in the first 43 cases without a preoperative CT scan planning. The second group includes the patients who underwent preoperative CT scan for entry point and screw trajectory planning (158 patients). Surgical procedures in the last group were performed with patient-matched 3D printed guide (37 patients). The accuracy in screws positioning was evaluated on postoperative CT scan.The mean follow-up was 32.3 months. Mean ODI and VAS index improved with statistical significance. Mean procedural time was 187, 142 and 124 min in the three subgroups. The total amount of recorded complications was 4.2% (16.3%, 3.8% and 0.0% respectively). Screws entirely within the cortex of the pedicle were 78.9%, 90.5% and 93.9% in the three groups. Fusion was obtained in 92.4% of cases.The CBT technique is a safe procedure, especially with an accurate preoperative CT scan-based planning. This seems more evident with the 3D template patient-matched guide. More studies are needed to directly compare traditional pedicle screws and CBT screws on long-term outcomes. |
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| Keywords: | Cortical bone trajectory Cortical pedicle screws Posterior lumbar fusion Minimally invasive surgery Planning 3D printed guide |
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