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Abstract
Posterior lumbar interbody fusion (PLIF) is a common surgical procedure and widely used in the treatment of lumbar degenerative disc disorders. Traditionally, posterior lumbar interbody fusion is done by using the traditional pedicle screw (PS) which offers great advantages, but at the same time it has some disadvantages which include the risk of superior facet joint violation and muscle damage. Recently, an alternative method of screw insertion via cortical bone trajectory (CBT) has been invented which has less invasive process and can be placed without the drawbacks associated with the traditional pedicle screw. However, it has to remain an interest whether CBT will provide similar or greater clinical outcomes compared to PS in PLIF. So the main aim of this review is to compare the clinical outcomes of cortical bone trajectory and traditional pedicle screw fixation in posterior lumbar interbody fusion based on the articles published on this topic. Compared to the traditional pedicle screw fixation, PLIF with CBT has similar clinical outcome based on pain intensity, ODI status and JOA score, as well as similar fusion rate and radiological evaluated complication such as loosening of screw. In addition PLIF with CBT has advantages of less facet joint violation, less blood loss, less intraoperative muscle damage and perioperative pain. On the basis of this study, we can suggest that PLIF with CBT can be considered as a reasonable alternative to PS in PLIF.
Highlights
Posterior lumbar interbody fusion is done by using the traditional pedicle screw (PS) which offers great advantages, but at the same time it has some disadvantages which include the risk of superior facet joint violation and muscle damage
The main aim of this review is to compare the clinical outcomes of cortical bone trajectory and traditional pedicle screw fixation in posterior lumbar interbody fusion based on the articles published on this topic
The mean VAS score for the low back pain was 7.6 ± 3.1 pre operatively to 2.0 ± 0.1 at postoperative 1 year in group A and from 7.7 ± 3.1 pre operatively to 2.1 ± 1.5 at postoperative 1 year in group B (p = 0.38) which indicate no significant difference between the group
Summary
The posterior lumbar interbody fusion (PLIF) technique has become the integral part among the spine surgeon in these modern days. This technique was performed routinely by only few surgeons due to its technical difficulties [2] [3]. In recent days PLIF surgery with the pedicle screw (PS) is used to treat certain lumbar pathologies such as spondylolisthesis, spinal disc herniation, spinal disc degeneration and the spine instability [4] [5] [6]. Advances in the spine surgery and a more general trend towards the adoption of less invasive procedure have led to the development of new and innovative techniques, which aim to achieve spinal fixation while causing less damage to surrounding tissues [13] [14]
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