Transpedicular Screw Fixation and Its Surgical Outcomes In The Management of Lumbar Instability: A Case Series of 107 Patients

Abstract

Objective:  Lumbar instability is a predominant pathology characterized by excessive and abnormal movement between two or more segments and is a significant cause of disability. In recent years, the transpedicular screw fixation system has been found to be successful in the management of spinal instabilities. The study aims to find out the surgical outcomes of TPF in radiological lumbar instability.

Materials & Methods:  This study was conducted on 107 patients at Ali Institute of Neurosciences, Irfan General Hospital, from June 2018 to December 2021, with a one-year follow-up period. Patients were recruited through non-probability convenience sampling. Inclusion criteria consisted of patients diagnosed with radiological lumbar instability evident on investigation findings. Exclusion criteria consisted of patients who were diagnosed with functional or non-radiological instability and those undergoing any procedure other than transpedicular screw fixation.

Results:  A total of 107 patients were treated for radiological lumbar instability through transpedicular screw fixation, out of which the majority of the participants were males (62%), followed by females (38%). The majority of the participants (75%) stated that the back pain was diminished completely or had minor episodes. Mean improvement on the visual analogue scale was observed to be 6 points (Pre-op VAS=8, Post op VAS=2). Neurological symptoms, including sensory and motor, demonstrated improvement in 90% of the patients.

Conclusion:  Transpedicular screw fixation (TPF) is a safe, effective surgical procedure associated with significant clinical outcomes. However, the procedure is associated with minor surgical and post-op complications. Postoperative physiotherapy may further enhance recovery in lumbar instability patients