Free hand technique lumbar spine pedicle screw placement in Indian population

Abstract

There are different pedicle screws entry point techniques are used for the lumbar pedicle screws placement. This study reported using confluence of pars, mamillary process, midpoint of transverse process, on lateral border of face joint as entry point of lumbar pedicle screws with free hand technique and the accuracy of this technique. Materials and Methods: A prospective study was done from may 2015 to November 2017 in our hospital using free hand technique lumbar pedicle screw placement includes 50 patients 270 screws. The diagnosis includes degenerative spine, trauma, and spondylolithesis. cortical breach by misplaced pedicle screw was determined by review of computed tomography. Results: Among the total 270 lumbar free hand placed pedicle screws, 10 screws with lateral breach, 1 screw inferior breach, 2 medial breach without significant neurological involvement with two cases of radicular pain which subsides over period of time without any revision. Conclusion: Free hand pedicle screw placement based on external landmark using confluence of pars, mamillary process, midpoint of transverse process, on lateral border of face joint as entry point of lumbar pedicle screws with free hand technique and the accuracy of this technique showed acceptable safety and accuracy and avoidance of radiation exposure.