Lumbar Percutaneous Pedicle Screws

Pedicle screws are used to stabilize the spine and allow the vertebrae to fuse. While the screws can be implanted during an open surgical procedure, the percutaneous procedure is minimally invasive. Potential benefits include:

Quicker return to normal activities
Less post-operative pain
Less damage to muscle and skin
Easier rehabilitation
Smaller scars
Less blood loss

Fusions are performed in patients with degenerative disk disease, spondylolysthesis, recurrent herniated disks, and spinal stenosis. Fusion is performed in these patients when conservative forms of treatment have failed.

In fusion of the lumbar spine two or more vertebral segments are joined together, eliminating movement in the joints. The procedure is performed with the hope of reducing pain caused by movement and compression of the nerve roots.

Pedicle screws have long been used to provide structural support to the spine allowing the joint space between the vertebral bodies to fuse. Screws are inserted into the pedicle of the vertebrae at the level above and below the disk space to be fused. A rod is then attached to solidly link both pedicle screws.

During the placement of conventional pedicle screws a considerable amount of muscle must be cut and stripped away from the bone in order to insert the screws. This can result in a lengthy healing time and considerable post operative pain for the patient. Minimally invasive percutaneous pedicle screw and rod placement eliminates the need to perform much of this cutting and stripping of muscle.

The percutaneous pedicle screw system (Medtronic’s Sextant is shown here) allows the screws and rods to be placed through small puncture wounds in the skin under x-ray fluoroscopic guidance.

Performing the Procedure

Fig. 1: The appropriate level is localized using x-ray fluoroscopy

Fig. 2: Guide tubes are inserted and screws are placed into the pedicles above and below the level to be fused..

Fig. 3: A rod is pushed through the skin and advanced through the heads of both pedicle screws .

Fig. 4: The applicating system is removed leaving the screws and rod in place.

Fig. 5: X-Ray showing pedicle screws and rods.

Your doctor will provide details of the procedure that is right for you as well as the benefits and risks. He will also provide instructions for your care before and after the procedure.