Stabilization in Spine Surgery
The Role of Posterior Fixation: Plates, Rods, and Screws
In recent years, there has been much progress in minimally invasive spine surgery. Spine surgeons today may use posterior fixation, such as percutaneous pedicle screws, facet screws, and spinous process plates, to stabilize your spine and facilitate fusion after decompression. Posterior means from the back side, so posterior fixation means inserting instruments on the back side of your spine in order to stabilize it.
This hardware, also called instrumentation, is a type of implant or medical device that's placed in your body. It typically comes in many shapes and sizes and is usually made of titanium or stainless steel.
Instrumentation is most commonly used for these spine conditions:
- Degenerative disc disease
- Scoliosis or other spinal deformities
- Trauma to your spine
- Spinal tumors
The Role of Spinal Instrumentation in Spine Surgery
Although different types of spinal instrumentation are used to treat different spine conditions, the main goal of all spinal instrumentation is the same: spinal stabilization.
Traditionally, spine surgery that involved instrumentation required a large incision, cutting of your muscles and tissues, and a long recovery. However, spine surgeons today can insert instrumentation minimally invasively.
The benefits of minimally invasive spinal instrumentation are:
- faster recovery
- smaller incision
- less cutting of muscles and tissues
- less scarring, blood loss, and risk of infection
Instrumentation is often used in conjunction with decompression—a type of minimally invasive spine surgery that takes pressure off (decompresses) your spinal cord or nerve roots.
Before inserting hardware, your surgeon will remove parts of your spine that are pressing on nerves (by doing, for example, a discectomy). This helps relieve pain and other symptoms, but it can create spinal instability, which means you can be more prone to excessive movement and even injury.
Instrumentation and fusion address this by using spinal instrumentation and bone graft to stabilize your spine.
Three commonly used instruments during spine surgery—percutaneous pedicle screws, facet screws, and spinous process plates—are described below.