Zeitschrift für Wirbelsäule

Minimally Invasive Multilevel Percutaneous Pedicle Screw Fixation for Lumbar Spinal Disease

Abstract

Sang Gu Lee, Seong Son, Chan Woo Park and Woo Kyung Kim

Objective: There are rare reports on the result of multilevel (≥ 3 levels) percutaneous pedicle screw fixation (PPF). The purpose of this study was to report the clinical experiences for multilevel PPF of the lumbar spine.

Methods: A total of 17 patients of lumbar spinal disease (7 degenerative diseases, 6 infectious diseases, and 4
traumatic instabilities) underwent neural decompression and multilevel PPF. There were 8 men and 9 women with a
mean age of 61.4 years (range: 25-84) and a mean follow-up period of 23.2 months (range: 13-48). The average PPF
level was 3.7. A retrospective review of clinical, radiological, surgical data was conducted.

Results: “Excellent” or “good” clinical results were obtained in 15 patients (88.2%). The average improvement of
visual analogue scale was 5.2 points (from 9.3 to 4.1), and the average improvement of Oswestry Disability Index was
36.2 (from 71.2 to 35.0) at the last visit (p<0.05).

The fusion rate was 88.2%, but, screw loosening was occurred in 2 patients, and adjacent segmental degeneration
was occurred in 2 patients. There was no statistical significance in the change of total lumbar lordotic angle. The
average operation time was 5.9 hours, with an EBL of 550 ml and bed rest duration of 2 days.

Conclusions: Although the current study examined a small sample with relatively short term follow up periods, our
study results demonstrate that multilevel PPF is feasible and safe for selective lumbar spinal disease.