Lumbar Spine Fusion Enhanced by Pedicle Screw Fixation

摘要

The indications for lumbar spine fusion are numerous, making a unified and discrete set of criteria impossible, The presence of symptomatic instability is arguably an acceptable indication irrespective of the cause of instability, be it degenerative, developmental, iatrogenic, or posttraumatic. Spinal stabilization with pedicle screws is always fortified with posterolateral or (preferably) interbody fusion. Notwithstanding the morbidity of pedicle screw fixation, these implants are appropriate and recommended for well-selected patients. Pedicle screw fixation supplemented with posterior lumbar inter-body fusion (PLIF) may have a slight edge over pedicle screw fixation supplemented with posterolateral fusion only. Threaded cages for interbody fusions are also being used with excellent results for lumbar spinal instability. Although cages for interbody fusion are generally easier to implant than pedicle screws, they are not suited for all patients with spinal instability. Some patients may prove candidates for both pedicle screws and threaded cages.