Minimization of the Number of Pedicular Screws Placing in the Degenerative Lumbar Spine
Pinit Hirunyachote MD*, Wallop Adukasem MD*
Affiliation : * Department of Orthopaedic Surgery, Nakhonpathom Hospital, Nakhonpathom
Objective : The present study was carried out to compare clinical results of spinal fusion in degenerative
disease of lumbar between using pedicular screw instrumentation in every pedicle and partial placing the
screws in some vertebra to provide immediate stabilization of the spine.
Material and Method: Fifty patients with degenerative diseases of their lumbar spines and needing spinal
fusion between 2004 and 2007 were included in this study. They were divided into two groups by the order of
their admissions. All underwent complete decompressive laminectomy and posterlateral fusion with autogenic
bone grafting. In the first group, 25 patients received pedicular screw instrumentation at all pedicles that
were in the fusion area. In the second group, 25 patients received pedicular screw instrumentation only in
particular pedicles to minimize the operative time, blood loss and the cost of instrumentation. Japanese
Orthopedic Association (JOA) Lumbar Scoring System was used to evaluate function outcome of the patients.
Results : There was no serious complication in both groups. Furthermore, there was no significant difference
in terms of operative time, amount of blood loss, time to bone union, and JOA lumbar score at the one-year
follow-up between the groups. However, the costs of instrumentation were significantly reduced in the second
group.
Conclusion : Minimizing the numbers of pedicular screws instrumentation for spinal fusion of degenerative
spine could be carried out to lessen the cost of treatment in particular patients.
Keywords : Pedicular screw, Degenerative lumbar spine, Spinal fusion
