European Spine Journal

, Volume 27, Supplement 2, pp 213–221 | Cite as

Cortical bone trajectory screws for circumferential arthrodesis in lumbar degenerative spine: clinical and radiological outcomes of 101 cases

  • Nicola Marengo
  • Pedro Berjano
  • Fabio Cofano
  • Marco Ajello
  • Francesco Zenga
  • Giulia Pilloni
  • Federica Penner
  • Salvatore Petrone
  • Lorenzo Vay
  • Alessandro Ducati
  • Diego Garbossa
Original Article



The use of cortical bone trajectory (CBT) pedicle screws for circumferential interbody fusion represents a viable alternative for single-level procedure with reduced invasiveness and less tissue destruction than the traditional technique. In addition, CBT screws have a potentially stronger pullout strength because of the greater amount of cortical bone intercepted. Only few series exist evaluating clinical and radiological outcomes of CBT screws.


This is a retrospective cohort study. All patients that underwent circumferential lumbar interbody fusion with CBT screws in our institution from 2014 to 2017 were reviewed. Patient demographics, clinical outcome with visual analogue scale (VAS) and Oswestry Disability Index (ODI), radiological data such as fusion, lordosis and muscle trauma, operative blood loss, hospital stay and use of fluoroscopy were evaluated.


A total of 101 patients undergoing CBT-arthrodesis for degenerative lumbo-sacral disease were reviewed. Mean procedural time was 187 min. The mean operative blood loss and X-ray dose per procedure was 383 ml and 1.60 mg cm2, respectively. The mean hospital stay was 3.47 days. The mean follow-up was 18.23 months. Mean lordosis increment at the treated level was 4.2°. When the follow-up was longer than 12 months (53% of patients), fusion was obtained in 94% of cases. Mean ODI and VAS index improved with statistical significance.


This is to our knowledge that the largest available study regarding CBT for circumferential arthrodesis. Results underlined the safety of this technique and the promising clinical and radiological outcomes that will need a longer follow-up.

Graphical abstract

These slides can be retrieved under Electronic Supplementary material.


Cortical bone trajectory Cortical pedicle screws Cortical screws Lumbar interbody fusion Spinal fusion Spinal fixation 


Conflict of interest

PB Honorarium for surgeon's education: Nuvasive, Medacta, Depuy Synthes. Grants for research: Nuvasive, Medacta, Depuy Synthes, K2M. No conflicts of interest were declared by the other authors.

Supplementary material

586_2018_5599_MOESM1_ESM.pptx (505 kb)
Supplementary material 1 (PPTX 505 kb)


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  • Nicola Marengo
    • 1
  • Pedro Berjano
    • 2
  • Fabio Cofano
    • 1
  • Marco Ajello
    • 1
  • Francesco Zenga
    • 1
  • Giulia Pilloni
    • 1
  • Federica Penner
    • 1
  • Salvatore Petrone
    • 1
  • Lorenzo Vay
    • 1
  • Alessandro Ducati
    • 1
  • Diego Garbossa
    • 1
  1. 1.Section of Neurosurgery, Division of NeuroscienceUniversity of TurinTurinItaly
  2. 2.G Spine 4IRCCS Orthopaedic Institute GaleazziMilanItaly

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