How I do it? Lumbar cortical bone trajectory fixation with image-guided neuronavigation

Acta Neurochir (Wien). 2019 Dec;161(12):2423-2428. doi: 10.1007/s00701-019-04067-0. Epub 2019 Oct 15.

Abstract

Background: Cortical bone trajectory was described in 2009 to reduce screw loosening in osteoporotic patients. Since then, it has demonstrated improvements in biomechanical and perioperative results compared to pedicle screws, and it have been described as a minimally invasive technique.

Method: We describe our experience with the technique assisted by 3D neuronavigation and review some of the complications and tools to avoid them together with limitations and pitfalls.

Conclusion: Cortical bone trajectory guided by 3D neuronavigation helps to reduce the need for radiation and incidence of complications.

Keywords: Cortical bone trajectory; Lumbar spine; Minimal invasive; Neuronavigation; Pars articularis.

MeSH terms

  • Cortical Bone / surgery
  • Humans
  • Imaging, Three-Dimensional / methods
  • Lumbar Vertebrae / surgery*
  • Neuronavigation / adverse effects
  • Neuronavigation / methods*
  • Pedicle Screws / adverse effects
  • Postoperative Complications / etiology*
  • Postoperative Complications / prevention & control
  • Spinal Fusion / adverse effects
  • Spinal Fusion / methods*