Southwest Scoliosis Institute’s board-certified, fellowship-trained orthopedic physicians Richard Hostin, MD, Shyam Kishan, MD, and Kathryn Wiesman, MD, have years of experience treating thousands of patients with complex spine conditions. We possess extensive knowledge and experience with “rods and pedicle screws” that are needed for each surgery. We spend lots of time studying and participating in research to ensure our patients get the correct procedure for their condition.
Pedicle Screws for Spine Fusion Rationale
The right combination of metal screws and rods (hardware) creates a solid “brace” that holds the vertebrae in place. These devices are intended to stop the movement from occurring between the vertebrae. These metal devices give more stability to the fusion site and allow the patient to get out of bed much sooner.
Spine Fusion Procedure
Spinal fusion permanently connects two or more vertebrae in your spine, eliminating motion between them. Spinal fusion involves techniques designed to mimic the normal healing process of broken bones.
The use of pedicle screws improves spinal fusion rates from approximately 60% to 90%. Many surgeons also believe that pedicle screws enhance patient recovery because they provide immediate stability for the spine and early mobilization for the patient.
Initially, the safety and effectiveness of using pedicle screws were called into question. However, the initial controversy has been favorably resolved and pedicle screws are now approved by the FDA for use in the lower (lumbar) spine for specific conditions.
However, the technique for placing the pedicle screws in the patient requires a steep learning curve, and only surgeons like Dr. Hostin, who is comfortable and experienced with the technique, should use them. A pedicle screw provides a means of gripping a spinal segment. The screws themselves act as firm anchor points that can then connect with a stabilizing rod.
Pedicle screws are then placed through the pedicle bone on the back of the spinal column. The screw inserts through the pedicle and into the vertebral body, one on each side. The screws grab into the bone of the vertebral body, giving them a good solid hold on the vertebra. With modern pedicle screws, the breakage rate has now been reduced to about one in 1,000.
Once the screws are placed they are attached to metal rods that connect all the screws together. When everything becomes bolted together and tightened, this creates a stiff metal frame that holds the vertebrae still so that healing can occur. The bone graft gets placed around the back of the vertebrae.
After the bone graft grows, the screws and rods are no longer needed for stability and can be safely removed with subsequent back surgery. However, most surgeons do not recommend removal unless the pedicle screws cause discomfort for the patient (5% to 10% of cases).
An analysis of 2,500 patients by 350 physicians conducted by the North American Spine Society found a very low complication rate using pedicle screws in spinal fusion surgery. Further, information discloses only about a one in 1,000 chance of nerve root damage, and a 2% to 3% chance of infection.
If you or a loved one suffers from spinal pain, you owe it to yourself to call Southwest Scoliosis Institute at 214-556-0555 to make an appointment.