Abstract
Introduction and Aims: Trans-laminar screw fixation is a popular method of posterior stabilisation when performing a 360-degree lumbar fusion, but many have concerns over the biomechanical stability of this construct. The objective of this paper is to compare the fusion rate and clinical outcome of this method with pedicle screw fixation.
Method: During 2001, 31 patients underwent combined anterior and posterior fusion by the two senior surgeons for the treatment of discogenic low back pain. Anterior interbody fusion was performed using the Syncage LR in all patients. Sixteen patients underwent trans-laminar screw fixation posteriorly and 15 underwent pedicle screw fixation. Fusion was assessed by fine cut CT scan at one year post-operatively. Function was assessed with pre- and post-operative Low Back Outcome Score and visual analogue pain scores.
Results: The average follow-up was 15.5 months. The incidence of pseudarthrosis in the trans-laminar screw group was approximately 80% (15 out of 19 levels), compared to 20% (4 of 21 levels) in the pedicle screw group (p < 0.05). There were trends towards greater improvements in the LBOS and VAS scores in the pedicle screw group. There were two surgical complications in the trans-laminar screw group and one in the pedicle screw group
Conclusion: The use of trans-laminar screws is associated with a significantly higher rate of pseudarthrosis compared to pedicle screw fixation. Assessing fusion with fine cut CT scans has revealed a higher rate of pseudarthrosis with trans-laminar screw fixation than has previously been reported
These abstracts were prepared by Editorial Secretary, George Sikorski. Correspondence should be addressed to Australian Orthopaedic Association, Ground Floor, The William Bland Centre, 229 Macquarie Street, Sydney, NSW 2000, Australia.
One or more of the authors are receiving or have received material benefits or support from a commercial source.
