Translaminar screw fixation in lumbar spine pathology. Technical note.

Two technical variations of the method of translaminar screw fixation for unstable lumbar and lumbosacral segments are presented. Distraction-arthrodesis with intraarticular bone grafts allows definitive enlargement of narrowed foramina with consecutive root decompression as well as repositioning and intracanalicular decompression in cases of instability after lumbar disc surgery and in degenerative spondylolisthesis. Reconstruction of a hemilamina after hemilaminectomy and facet reduction allows reconstitution of the spinal canal and its posterior parts as well as direct treatment of intraforaminal pathology.