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Comparison of Cortical Bone Trajectory to Pedicle-Based Dynamic Stabilization: An Analysis of 291 Patients

OBJECTIVE: Pedicle-based dynamic stabilization (DS) has gained popularity outside of America. Although pedicle screw (PS) loosening has always been a concern, it is reportedly innocuous. Cortical bone trajectory (CBT) screw is an emerging option with less invasiveness and similar effectiveness to PS...

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Autores principales: Chang, Chih-Chang, Chang, Hsuan-Kan, Ko, Chin-Chu, Wu, Ching-Lan, Kuo, Yi-Hsuan, Tu, Tsung-Hsi, Huang, Wen-Cheng, Wu, Jau-Ching
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Korean Spinal Neurosurgery Society 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10080437/
https://www.ncbi.nlm.nih.gov/pubmed/37016878
http://dx.doi.org/10.14245/ns.2244888.444
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author Chang, Chih-Chang
Chang, Hsuan-Kan
Ko, Chin-Chu
Wu, Ching-Lan
Kuo, Yi-Hsuan
Tu, Tsung-Hsi
Huang, Wen-Cheng
Wu, Jau-Ching
author_facet Chang, Chih-Chang
Chang, Hsuan-Kan
Ko, Chin-Chu
Wu, Ching-Lan
Kuo, Yi-Hsuan
Tu, Tsung-Hsi
Huang, Wen-Cheng
Wu, Jau-Ching
author_sort Chang, Chih-Chang
collection PubMed
description OBJECTIVE: Pedicle-based dynamic stabilization (DS) has gained popularity outside of America. Although pedicle screw (PS) loosening has always been a concern, it is reportedly innocuous. Cortical bone trajectory (CBT) screw is an emerging option with less invasiveness and similar effectiveness to PS in short-segment lumbar fusion. This study aimed to verify the use of CBT for DS by comparing the outcomes between pedicle- and CBT-based DS. METHODS: Consecutive patients with lumbar spondylosis or low-grade spondylolisthesis who underwent 1- or 2-level DS between L3–5 with a minimum follow-up of 24 months were reviewed. Screw loosening was determined by computed tomography and the incidences were compared. RESULTS: A total of 291 patients who underwent Dynesys DS (235 pedicle- and 56 CBT-based, respectively) were compared. The demographics and preoperative conditions were similar. All the clinical outcomes improved at 24-month postoperation, while the CBT-based group had less operation time and blood loss than the pedicle-based group. The rates of screw loosening were lower in the CBT-based (5.4% per screw and 12.5% per patient) than the pedicle-based group (9% per screw and 26.4% per patient). Furthermore, there were no differences in the clinical outcomes and complication profiles. CONCLUSION: The CBT-based DS for 1- or 2-level lumbar degeneration demonstrated equivalent clinical improvement as the pedicle-based DS. The adaption of CBT-based screws for DS could be a less invasive approach (shorter operation time and less blood loss), with lower chances of screw loosening than the conventional PS-based DS.
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spelling pubmed-100804372023-04-08 Comparison of Cortical Bone Trajectory to Pedicle-Based Dynamic Stabilization: An Analysis of 291 Patients Chang, Chih-Chang Chang, Hsuan-Kan Ko, Chin-Chu Wu, Ching-Lan Kuo, Yi-Hsuan Tu, Tsung-Hsi Huang, Wen-Cheng Wu, Jau-Ching Neurospine Original Article OBJECTIVE: Pedicle-based dynamic stabilization (DS) has gained popularity outside of America. Although pedicle screw (PS) loosening has always been a concern, it is reportedly innocuous. Cortical bone trajectory (CBT) screw is an emerging option with less invasiveness and similar effectiveness to PS in short-segment lumbar fusion. This study aimed to verify the use of CBT for DS by comparing the outcomes between pedicle- and CBT-based DS. METHODS: Consecutive patients with lumbar spondylosis or low-grade spondylolisthesis who underwent 1- or 2-level DS between L3–5 with a minimum follow-up of 24 months were reviewed. Screw loosening was determined by computed tomography and the incidences were compared. RESULTS: A total of 291 patients who underwent Dynesys DS (235 pedicle- and 56 CBT-based, respectively) were compared. The demographics and preoperative conditions were similar. All the clinical outcomes improved at 24-month postoperation, while the CBT-based group had less operation time and blood loss than the pedicle-based group. The rates of screw loosening were lower in the CBT-based (5.4% per screw and 12.5% per patient) than the pedicle-based group (9% per screw and 26.4% per patient). Furthermore, there were no differences in the clinical outcomes and complication profiles. CONCLUSION: The CBT-based DS for 1- or 2-level lumbar degeneration demonstrated equivalent clinical improvement as the pedicle-based DS. The adaption of CBT-based screws for DS could be a less invasive approach (shorter operation time and less blood loss), with lower chances of screw loosening than the conventional PS-based DS. Korean Spinal Neurosurgery Society 2023-03 2023-03-31 /pmc/articles/PMC10080437/ /pubmed/37016878 http://dx.doi.org/10.14245/ns.2244888.444 Text en Copyright © 2023 by the Korean Spinal Neurosurgery Society https://creativecommons.org/licenses/by-nc/4.0/This is an open access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) ) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Article
Chang, Chih-Chang
Chang, Hsuan-Kan
Ko, Chin-Chu
Wu, Ching-Lan
Kuo, Yi-Hsuan
Tu, Tsung-Hsi
Huang, Wen-Cheng
Wu, Jau-Ching
Comparison of Cortical Bone Trajectory to Pedicle-Based Dynamic Stabilization: An Analysis of 291 Patients
title Comparison of Cortical Bone Trajectory to Pedicle-Based Dynamic Stabilization: An Analysis of 291 Patients
title_full Comparison of Cortical Bone Trajectory to Pedicle-Based Dynamic Stabilization: An Analysis of 291 Patients
title_fullStr Comparison of Cortical Bone Trajectory to Pedicle-Based Dynamic Stabilization: An Analysis of 291 Patients
title_full_unstemmed Comparison of Cortical Bone Trajectory to Pedicle-Based Dynamic Stabilization: An Analysis of 291 Patients
title_short Comparison of Cortical Bone Trajectory to Pedicle-Based Dynamic Stabilization: An Analysis of 291 Patients
title_sort comparison of cortical bone trajectory to pedicle-based dynamic stabilization: an analysis of 291 patients
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10080437/
https://www.ncbi.nlm.nih.gov/pubmed/37016878
http://dx.doi.org/10.14245/ns.2244888.444
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