Percutaneous Transpedicular Interbody Fusion Technique in Percutaneous Pedicle Screw Stabilization for Pseudoarthrosis Following Pyogenic Spondylitis

This report introduces a percutaneous transpedicular interbody fusion (PTPIF) technique in posterior stabilization using percutaneous pedicle screws (PPSs). An 81-year-old man presented with pseudoarthrosis following pyogenic spondylitis 15 months before. Although no relapse of infection was found, he complained of obstinate low back pain and mild neurological symptoms. Radiological evaluations showed a pseudoarthrosis following pyogenic spondylitis at T11–12. Posterior stabilization using PPSs from Th9 to L2 and concomitant PTPIF using autologous iliac bone graft at T11–12 were performed. Low back pain and neurological symptoms were immediately improved after surgery. A solid interbody fusion at T11–12 was completed 9 months after surgery. The patient had no restriction of daily activity and could play golf at one year after surgery. PTPIF might be a useful option for perform segmental fusion in posterior stabilization using PPSs.

[1]  R. Mobbs,et al.  Minimally Invasive Percutaneous Fixation Techniques for Metastatic Spinal Disease , 2014, Orthopaedic surgery.

[2]  O. Bradáč,et al.  Treatment of thoracolumbar trauma by short-segment percutaneous transpedicular screw instrumentation: prospective comparative study with a minimum 2-year follow-up. , 2014, Journal of neurosurgery. Spine.

[3]  A. Frati,et al.  Pure percutaneous pedicle screw fixation without arthrodesis of 32 thoraco-lumbar fractures: clinical and radiological outcome with 36-month follow-up , 2013, European Spine Journal.

[4]  Michael Y. Wang.  Improvement of sagittal balance and lumbar lordosis following less invasive adult spinal deformity surgery with expandable cages and percutaneous instrumentation. , 2013, Journal of neurosurgery. Spine.

[5]  S. Moon,et al.  Transpedicular Curettage and Drainage of Infective Lumbar Spondylodiscitis: Technique and Clinical Results , 2012, Clinics in orthopedic surgery.

[6]  Ralph J. Mobbs,et al.  Technique, challenges and indications for percutaneous pedicle screw fixation , 2011, Journal of Clinical Neuroscience.

[7]  W. Yue,et al.  Clinical and Radiological Outcomes of Minimally Invasive Versus Open Transforaminal Lumbar Interbody Fusion , 2009, Spine.

[8]  V. Vougioukas,et al.  Minimally invasive dorsal percutaneous spondylodesis for the treatment of adult pyogenic spondylodiscitis , 2009, Acta Neurochirurgica.

[9]  N. Anand,et al.  Minimally Invasive Multilevel Percutaneous Correction and Fusion for Adult Lumbar Degenerative Scoliosis: A Technique and Feasibility Study , 2008, Journal of spinal disorders & techniques.

[10]  M. Fazir,et al.  Percutaneous transpedicular biopsy of the spine. , 2007, The Medical journal of Malaysia.

[11]  Kevin T Foley,et al.  Percutaneous pedicle screw fixation of the lumbar spine: preliminary clinical results. , 2002, Journal of neurosurgery.

[12]  T. Lowe,et al.  Unilateral Transforaminal Posterior Lumbar Interbody Fusion (TLIF): Indications, Technique, and 2-Year Results , 2002, Journal of spinal disorders & techniques.

[13]  A. Hadjipavlou,et al.  Percutaneous transpedicular discectomy and drainage in pyogenic spondylodiscitis. , 1998, American journal of orthopedics.

[14]  P. Lander,et al.  Percutaneous transpedicular biopsy of the spine. , 1994, Spine.

[15]  F. Magerl,et al.  Treatment of osteomyelitis of the spine using percutaneous suction/irrigation and percutaneous external spinal fixation. , 1994, Journal of spinal disorders.

[16]  R. B. Cloward.  The treatment of ruptured lumbar intervertebral discs by vertebral body fusion. I. Indications, operative technique, after care. , 1953, Journal of neurosurgery.