Screw Fixation In Spine High Impact Factor Journals

Continuing controversy over the use of pedicular fixation in the United States is promoted by the lack of governmental approval for the marketing of these devices due to safety and efficacy concerns. These implants have meanwhile become an invaluable part of spinal instrumentation in Europe. With reference to the North American view, there's a scarcity of comprehensive reviews that consider the historical evolution of pedicle screw systems, the rationales for his or her application, and the clinical outcome from a European perspective. This literature review suggests that pedicular fixation may be a relatively safe procedure and isn't related to a significantly higher complication risk than non-pedicular instrumentation. Pedicle screw fixation provides short, rigid segmental stabilization that permits preservation of motion segments and stabilization of the spine within the absence of intact posterior elements, which isn't possible with non-pedicular instrumentation. Fusion rates and clinical outcome in the treatment of thoracolumbar fractures appear to be superior to that achieved using other forms of treatment. For the correction of spinal deformity (i.e., scoliosis, kyphosis, spondylolisthesis, tumor), pedicular fixation provides the theoretical advantage of rigid segmental fixation and of facilitated deformity correction by a posterior approach, but the clinical relevance thus far remains unknown. In low-back pain disorders, a literature analysis of 5,600 cases of lumbar fusion with different techniques reveals a trend that pedicle screw fixation enhances the fusion rate but not clinical outcome.    

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