• Cornelius Wimmer.
• CA Klinik für Wirbelsäulenchirurgie mit Skoliosezentrum, Vogtareuth, Germany. cwimmer@schoen-kliniken.de
• Oper Orthop Traumatol. 2008 Dec 1; 20 (6): 511-24.

ObjectiveFusion can be done from the thoracic spine up to the sacrum. A cannulated Expedium screw as well as the rod can be placed percutaneously. This minimally invasive approach creates only a minor muscular trauma.IndicationsOsteochondrosis of the lumbar and thoracic spine. Spondylolisthesis grade I-III according to Meyerding. Instability after nucleotomy. Type A and B fractures according to Magerl. Spondylodiscitis. Flexible scoliosis of the lumbar and thoracic spine.ContraindicationsOsteoporosis (t score < -1.5). Spondylolisthesis grade IV according to Meyerding.Surgical TechniqueThe patient should be positioned prone, lying flat on the table. Use of two C-arms, one in anteroposterior and the other in lateral view. Marking of the entry point of the pedicle on the skin. Short skin incision (15 mm). Insertion of the Jamshidi needle into the pedicle. A guide wire should be inserted. Removal of the needle and start with the dilatation system, first the small one and then the big one. Preparation of the pedicle with a tap and insertion of the pedicle screw with the open and closed extension sleeves. Measurement of the rod length and insertion of the rod. Fixation of the rod with screw and removal of the extension sleeves.Postoperative ManagementThe patient should be mobilized on the same day or the 1st day after surgery with or without a corset.ResultsFrom 2005 to 2006, 72 patients (45 female, 27 male) with a mean age of 44 years (35-73 years) were treated using this technique. Follow-up examinations were performed 3, 6, 12, and 24 months after surgery. The mean follow-up was 14 months (3-24 months). Fusion rate was evaluated by computed tomography scan or X-ray. Implant-related complications were not observed.

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