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The Cortical Bone Trajectory for Pedicle Screw Insertion

Kaye, I. David MD1; Prasad, Srinivas K. MD2; Vaccaro, Alex R. MD, PhD, MBA1; Hilibrand, Alan S. MD1

doi: 10.2106/JBJS.RVW.16.00120
Review Article
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Disclosures

  • ➢ The cortical bone trajectory takes advantage of a cortically based track through the pedicle, which may result in improved fixation strength compared with a traditionally placed pedicle screw.
  • ➢ The cortical track is a medially to laterally, caudally to cranially directed path that allows for less soft-tissue dissection during insertion, making it amenable to minimally invasive techniques and useful in cases of trauma and adjacent segment disease.
  • ➢ Complications with this new technology have been low, and outcome studies have demonstrated excellent fusion rates as well as maintenance of reduction in cases of spondylolisthesis.
  • ➢ Early promising results should be tempered with reports of failure during early implementation; a learning curve exists and ultimately, larger, prospective, high-quality studies are necessary before the advantages of cortical screw instrumentation can truly be quantified.

1The Rothman Institute at Thomas Jefferson University Hospital, Philadelphia, Pennsylvania

2Thomas Jefferson University Hospital, Philadelphia, Pennsylvania

Copyright © 2017 by The Journal of Bone and Joint Surgery, Incorporated
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