Cortical Bone Trajectory Versus Traditional Pedical Screw In Transforaminal Lumbar Interbody Fusion

ObjectiveTo compare the clinical and radiological outcomes of Cortical Bone Trajectory(CBT)VS.Traditional Pedical Screw(PS)used in Transforaminal Lumbar Interbody Fusion(TLIF).MethodsFrom April 2016 to October 2017,50 patients with osteoporosis lumbar degenerative diseases after invalid conservative treatment,who are candidates for TLIF surgery will be randomly allocated to either the CBT-TLIF group or the PS-TLIF group.Twenty-Five patients with CBT-TLIF were compared with Twenty-Five matched PS-TLIF controls.A short-term follow-up and a statistical analysis of perioperative and short-term clinical outcomes were performed.In the same time,the potential complications were evaluated.ResultsBlood lost were significantly shorter in the CBT-TLIF group than that in the PS-TLIF group(P<0.05).No difference in operative duration length of stay and duration to ambulation were found.Significant improvements in the Oswestry disability index(ODI)functional scores and Visual Analogue Scale(VAS)were observed at 3-,6-,and 12-months in both groups,but no significant difference was found between the both groups.One patient aged 68 happened screw loosing sign postoperative 6 months at PS-TLIF group due to osteopenia morbidity.Another one aged 45 arise screw breaking the pedical medial walland nerve root irritation postoperative 1st day at PS-TLIF group and followed by correcting screw position immediately.Subsequently,the signs disappeared.ConclusionCBT-TLIF and PS-TLIF had comparable functional benefits,while CBT-TLIF had superiority in blood control and temporary interbody stability,particularly in patients with osteoporosis and obesity.