Hole modular anchorage (HMA) screws for anterior transvertebral fixation in high-grade spondylolisthesis instances requiring 360 levels in-situ fusion.
Br J Neurosurg. 2018 Mar 22;:1-5
Authors: König MA, Boszczyk BM
OBJECTIVE: 360 levels in-situ fusion for high-grade spondylolisthesis confirmed satisfying medical long-term outcomes. Combining anterior with posterior surgical procedure will increase fusion charges. Anteriorly inserted transvertebral HMA screws might be a substitute for strut graft constructs or cages, avoiding donor web site issues. As well as, full posterior muscle detachment is prevented and the damage danger of neural buildings is minimized. This examine investigates using HMA screws on this context.
MATERIAL AND METHODS: 5 consecutive sufferers requiring L4-S1 in-situ fusion for isthmic spondylolisthesis (4 Grade three and one Grade four) had been included. The L5/S1 degree was fused with an HMA screw full of native bone and bone morphogenic protein (BMP2), inserted through the L4/5 disc area degree. An L4/5 stand-alone interbody fusion with extra minimal invasive posterior screw fixation was added.
RESULTS: Transvertebral insertion of the HMA machine was completed through a retroperitoneal method to L4/L5 in all instances with out publicity of L5/S1. Blood loss ranged from 150?ml-350?ml. No intraoperative complication occurred. One affected person developed posterior wound an infection requiring debridement. Stable fusion was confirmed with a CT scan after 6 months in all sufferers. All sufferers improved to unrestricted actions of each day residing with two being restricted by occasional again ache.
CONCLUSIONS: HMA screws enable for efficient lumbosacral fusion through a restricted anterior publicity. That is technically simpler than posterior publicity of the lumbosacral junction in high-grade spondylolisthesis requiring 360 levels fusion.
PMID: 29564921 [PubMed – as supplied by publisher]