Tengfei Song1, Wellington K Hsu2, Tianwen Ye3. 1. Department of Orthopaedic Surgery, Shanghai Changzheng Hospital, Second Military Medical University, Shanghai 200003, China. 2. Department of Orthopaedic Surgery, Nothwestern Memorial Hospital, Nothtwestern University, Chicago 60611, IL, USA. 3. Department of Orthopaedic Surgery, Shanghai Changzheng Hospital, Second Military Medical University, Shanghai 200003, China. Email: yetianwenvip@126.com; yetianwen@hotmail.com.
Abstract
OBJECTIVE: The purpose of this study was to demonstrate the lumbar pedicle cortical bone trajectory (CBT) screw fixation technique, a new fixation technique for lumbar surgery. DATA SOURCES: The data analyzed in this review are mainly from articles reported in PubMed published from 1994 to 2014. STUDY SELECTION: Original articles and critical reviews relevant to CBT technique and lumbar pedicle fixation were selected. RESULTS: CBT technique was firstly introduced as a new fixation method for lumbar pedicle surgery in 2009. The concepts, morphometric study, biomechanical characteristics and clinical applications of CBT technique were reviewed. The insertional point of CBT screw is located at the lateral point of the pars interarticularis, and its trajectory follows a caudocephalad path sagittally and a laterally directed path in the transverse plane. CBT technique can be used for posterior fixation during lumbar fusion procedures. This technique is a minimally invasive surgery, which affords better biomechanical stability, fixation strength and surgical safety. Therefore, CBT technique has the greatest benefit in lumbar pedicle surgery for patients with osteoporosis and obesity. CONCLUSION: CBT technique is a better alternative option of lumbar pedicle fixation, especially for patients with osteoporosis and obesity.
OBJECTIVE: The purpose of this study was to demonstrate the lumbar pedicle cortical bone trajectory (CBT) screw fixation technique, a new fixation technique for lumbar surgery. DATA SOURCES: The data analyzed in this review are mainly from articles reported in PubMed published from 1994 to 2014. STUDY SELECTION: Original articles and critical reviews relevant to CBT technique and lumbar pedicle fixation were selected. RESULTS: CBT technique was firstly introduced as a new fixation method for lumbar pedicle surgery in 2009. The concepts, morphometric study, biomechanical characteristics and clinical applications of CBT technique were reviewed. The insertional point of CBT screw is located at the lateral point of the pars interarticularis, and its trajectory follows a caudocephalad path sagittally and a laterally directed path in the transverse plane. CBT technique can be used for posterior fixation during lumbar fusion procedures. This technique is a minimally invasive surgery, which affords better biomechanical stability, fixation strength and surgical safety. Therefore, CBT technique has the greatest benefit in lumbar pedicle surgery for patients with osteoporosis and obesity. CONCLUSION: CBT technique is a better alternative option of lumbar pedicle fixation, especially for patients with osteoporosis and obesity.
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