Fixing of the lumbar column aided by simple radiological techniques

Fixing of the lumbar vertebral column aided by simple radiological techniques facilitates the process and avoids complications. This technique has arisen as a result of the conclusion of the PhD thesis by Dr. Matías Alfonso, specialist in the Department of Orthopaedic and Bone Surgery at the University Hospital of Navarre, and has been based on research carried out on a pedicular screw method based on intraoperatorial anatomical references. The study has been applied to 44 patients attending the University Hospital.

The insertion of pedicular screws into the lumbar vertebral column is suitable for the treatment of fractures, problems of instability due to degenerative illness, tumours, etc. It involves a routine technique in orthopaedics and bone surgery. Nevertheless, lesion of the nerve roots can occur as a complication, a risk that can affect up to 3% of patients.

The University Hospital has evaluated a method to guarantee the pedicular screw system in a reliable way, avoiding the neurological complications. This system groups together a series of radiological projections by means of which we can see to the borders of the vertebrae, thus enabling the path of the screws to be ascertained with precision.

Adventages

The PhD research undertaken by Dr. Alfonso confirms that the pedicular screw system based on the radiological method obtains results similar to those produced by computer-assisted surgery. Moreover, the added advantage is that it is a much simpler procedure that has no need of neuronavigators, thus considerably reducing health costs.

Another of the study’s conclusions related to the shape of the vertebrae and the location of the injury. The method used in order to evaluate, in a preoperational manner, the shape and size of the vertebrae, enable us to know the width and length of the screws that we have to use and in which direction they have to go.

Finally, this research has demonstrated its usefulness in reliably determining the position of the screws once introduced and terminated the operation. After analysing the appearance of the inside of the vertebra, we have observed that 5.5 mm width screws appear as measuring up to 8 mm on the scanner. That is to say, our method has detected that the TAC image obtained can show that part of the screw is outside the vertebra when, in reality, this is not the case!