Overview of Surgical Techniques and Implants

Abstract

Posterior lumbar spine surgery uses various access routes (midline, lateral, far-lateral paracoccygeal) and can employ classic open, mini-open (microscopic or video assisted) or percutaneous access techniques. Decompression operations can be performed by using these access methods, and there are various possibilities of instrumentation as can various forms of instrumentation. The implants are divided into the following groups: rigid systems (internal fixator systems such as rod-screw or screw-plate systems, screws, pedicle screw-hook systems, cages and spacers for interbody fusion); different dynamic or semirigid systems; and so-called nonfusion systems (pedicle-based systems, interspinous spacers, facet replacements). The following are types of posterior stabilisation systems available: tulip screw–type systems, side-loading systems and plate systems. For the interbody fusion, there are cages in titanium as well as in PEEK on the market. Also, there are implants for the motion preservation available. The spectrum of those implants rises from dynamic pedicle screw systems, interspinous spacers and facet replacement implants.