Abstract

In recent years, 360 degree (circumferential) fusion is accepted as gold standard for the surgical treatment of lumbar spinal instability. The advantages of this technique are high fusion rate, protection of lumbar lordosis, and less posterior spinal construct failure rates. Various 360 degree fusion techniques had been described previously, but most of them can carry some risk factors. Posterior transpedicular screw-rod fixation can be performed also percutaneously using "Sextant" system as a minimally invasive technique, but all interbody fusion techniques that described before (ALIF, PLIF, TLIF) are open, mini-open or laparoscopic and it is hard to mention about real minimal invasiveness while applying these procedures. Mini laparatomy, retroperitoneal approach, video-assisted systems are presented as to damage less tissue and improve outome of the patients. These techniques may decrease complication rate but carry all of the risks of open surgery. In this presentation, we present a new, real minimally invasive 360 degree fusion using percutaneous screw-rod system (Sextant system, Medtronic, Sofamor Danek, Memphis , TN ) and expandable intervertebral cages (B-Twin expandable spinal spacer, Disc-O-Tech, Telaviv-Israel) in cases with lumbar spinal instability without neural compression.