Application of percutaneous pedicle screw fixation for lumbar degenerative disease

Objective To evaluate the accuracy and safety of mini-invasive and percutaneous pedicle screw fixation with fluoroscopy for lumbar degenerative disease. Methods For this retrospective study, 64 cases of lumbar degenerative disease underwent mini-invasive transforaminal lumbar interbody fusion (TLIF) under microscope plus percutaneous pedicle screw fixation with fluoroscopy of lumbar spine from March 2012 to October 2013. The parameters of operative duration, intraoperative blood loss volume, hospital stay and complications were recorded and analyzed. The clinical outcomes were assessed with visual analog scale (VAS), Oswestry disability index (ODI) and Short Form Health Survey-36 (SF-36). The relevant examinations included plain radiography, dynamic radiology and lumbar magnetic resonance imaging (MRI) and computed tomography (CT). Results The mean estimated blood loss volume was (193±100) ml, mean length of hospital stay (7±2) days, mean operative duration (3.4±0.9) hours and an overall complication rate 7.8%. Significant differences existedin mean VAS score and ODI between pre- and post-operation (P<0.01). During a mean follow-up of 3 months, the improvement rate of ODI was 50.8% and mean SF-36 86.2%. A total of 316 screws were implanted into 64 patients. Among them, 306 were well-positioned and 10 fairly. The success rate of screw implantation was 100%. And solid fusion was achieved in 64 patients (96%). Conclusion Mini-invasive and percutaneous pedicle screw fixation with fluoroscopy for lumbar degenerative disease is both efficacious and safe. And it may be combined with TLIF technique under microscope. Key words: Mini-invasive surgery; Percutaneous pedicle screw; Lumbar degenerative disease