The Multiple Trajectory Anchoring Technique for Lumbar Sacral Fusion: An Alternative Solution for Spinal Fixation

Abstract

Cortical bone trajectory (CBT) screw was firstly utilized by Santoni in 2009, which had been proved to have stronger hold force, especially in the osteoporosis vertebrae compared with the pedicle screw (PS). In this study, we developed a technique combining pedicle screw, cortical bone trajectory screw, and sacral alar screw, which was named as multiple trajectory anchoring (MTA) technique for patients who underwent lumbar-sacral fusion. The technique comes with the following improvements and advantages. First, the satellite rods are fixed with the additional screws which makes the tension more dispersed and avoids stress concentration. Second, the interaction between the multi-trajectory screws anchoring on one vertebra makes the screws stronger and reduce the risk of screw loosening. Third, the MTA screw can provide better stability for the anterior column. Forth, the MTA fixation can not only strengthen the construct, but also provide additional correction force. In this chapter, we aimed to introduce an original lumbar-sacral strengthening technique, multiple trajectory anchoring(MTA), for lumbar-sacral fusion. It is a safe and effective means to strengthen lumbar-sacral internal fixation as well as provide additional correction force for patients with lumbar-sacral degeneration, deformity and tumor. More importantly, it provides an alternative solution for pelvic fixation.