Basics and Recent Advances in Lumbar Spinal Fixation

Abstract

  Lumbar spinal fixation surgery is often selected to treat low back pain and the neurological symptoms of cauda equina and nerve root disorders. Lumbar spondylolisthesis, lumbar disc disease and foraminal stenosis, all of which have lumbar instability and bony degeneration, are indications for lumbar spinal fixation with interbody fusion, postero-lateral fusion and posterior fusion. Fixation surgery contributes to the improvement of low back pain and lower extremity pain in the short term, but if the procedure becomes complicated, the incidence of complications also increases, and adjacent spine degeneration becomes a problem in the long term. Therefore, it is important to be aware that surgical procedure selection is a major factor in the patient’s prognosis.

  In this article, we describe the basic procedure for fixation in lumbar degenerative diseases, and describe the details of the procedure, such as posterior lumbar interbody fusion and postero-lateral fusion, based on the patient’s historical background. In addition, the recently developed minimally invasive techniques, such as the percutaneous pedicle screw, the cortical bone trajectory screw and lateral lumbar interbody fusion are discussed, and their features and effectiveness are explained.