A Narrative Review on Pedicle Screw Instrumentation in the Lumbar Spine

Pedicle screw (PS) fixation in the lumbar spine provides immediate stability and rigid fixation without sacrificing adjacent motion segments. This study was done to provide a narrative review of the evolution and technology of PS insertion with a focus on only lumbar spine. PS are the most widely us...

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Bibliographic Details
Main Authors: Abhijith Anil, Ajay Krishnan, Bharat R. Dave, Devanand Degulmadi
Format: Article
Language:English
Published: Wolters Kluwer Medknow Publications 2025-01-01
Series:Indian Spine Journal
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Online Access:https://doi.org/10.4103/isj.isj_4_24
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Summary:Pedicle screw (PS) fixation in the lumbar spine provides immediate stability and rigid fixation without sacrificing adjacent motion segments. This study was done to provide a narrative review of the evolution and technology of PS insertion with a focus on only lumbar spine. PS are the most widely used anchors in spinal constructs. However, there is wide variation in techniques of screw insertion from surgeon to surgeon. While generally safe, PS insertion if done incorrectly can have catastrophic complications. This review also provides an update on enabling technology that can be used to avoid malposition of screws. A literature search was conducted on PubMed and articles relevant to lumbar spine PS instrumentation were reviewed. We have described various techniques of PS insertion in terms of their entry points, trajectory, and directional guidance. The biomechanical principles underlying PS fixation and the parameters to select the optimal screw are described. Recent advances in technology that aim to improve the safety and ease of PS insertion are also discussed.
ISSN:2589-5079
2589-5087