Are there alternatives to the use of pedicle screws?
Threaded Cage Fusion
Surgical fusion of the vertebrae is a type of procedure in which two or more vertebrae are held together, usually by some sort of metallic fixation device, until the vertebrae can grow together, by way of a bone graft, placed at surgery. Based upon earlier approaches using bone, placement of interbody fusion devices (“cages”) is a relatively recent innovation in the treatment of instability, recurrent intervertebral disc protrusion, and other related conditions.
This technique permits immediate stabilization across a motion segment, or interspace, and has proven safe and very effective, in appropriate patients, leading to solid, bony fusion. Although this is not, strictly speaking, a minimally invasive approach, it requires considerably less operative exposure of normal tissues than the older methods of posterior instrumentation, using pedicle screws and rods or plates.
Note should be made that smoking, while not an absolute contraindication to surgical fusion, has been shown to interfere with bone formation and fusion, leading to a higher percentage of non-union (failed fusion). It is strongly recommended that any patient intending to undergo a fusion procedure discontinue smoking at least 6 weeks prior to surgery and not resume smoking following surgery. Use of nicotine patches is not recommended, as nicotine, itself, is considered to be one of the agents responsible for bone toxicity.