Functional outcome and fusion rates of translaminar screw fixation of the lumbar and lumbosacral spine: A case series

Pedicle screw fixation has been the gold standard because this technique allows solid arthrodesis and provides a degree of stiffness that immediately diminishes mechanical back pain. Although the translaminar screw technique is considered inferior to the pedicle screw technique due to the thought that it is minimally invasive, studies proved that both fixation systems had significantly greater stiffness and reduced range of motion compared with the normal vertebrae. The purpose of this study is to determine the fusion rate, the clinical outcome of translaminar screw fixation of the lumbar and lumbosacral for the long term. We evaluate six patients with a degenerative lumbar disorder and performed posterior lumbar fixation and fusion with the translaminar screw. The translaminar screw was performed monosegmentally (3 patients), across two segments (1 patient), and across three segments (2 patients). We then evaluate Oswestry Disability Index (ODI) score one week, three months, and one year postoperatively. When lumbosacral spine fusion procedures are performed without supplemental internal fixation, a 10% pseudoarthrosis rate can be expected for single-level fusions, and the percentage can reach 30% if more than two levels are fused. Compared to the pedicle screw technique, the translaminar technique provides a limited profile and less bony invasion that will minimize the risk of failure. Translaminar screw offers immediate postoperative stability, seen in postoperatively, patients experienced better quality of life than preoperatively. It also represents a useful and inexpensive technique for short segment fusion of the non-traumatic lumbar and lumbosacral spine. •Subjective assessment showed all patients experienced symptoms relieved post-surgery.•The translaminar technique provides less bony invasion to minimize the risk of failure.•The biomechanical test reveals translaminar screw increased the stiffness 2.4 times.•This technique can be an alternative for fusions in the degenerative lumbar disease.