Transmuscular approach for the implantation of lumbar transpedicular screws. A less invasive strategy for a classical technique.

Solapas principales

Hernández P.1, Pereda P.1, Aramburu I.1, Casteluccio G. 1



            The lumbosacral spinal degenerative disease is an important cause of disability. The management is a challenge because the medical intervention must not cause more suffering. This should be a priority to keep in mind when deciding whether to operate a pacient or not.

When an arthrodesis is necessary to carry out, is very important to respect the muscles and joints during the approach.

Compare the results between the lumbosacral transpedicular screws implant with the classical approach, in which a large muscle desinsertion is developed, as the transmuscular approach. Its costs has also been evaluated.

A retrospective descriptive study was made to analyze the patients subjected to an instrumented arthodesis by the same neurosurgeon. One hundred and two patients were operated between march 2006 and march 2018. Twenty five were subjected to a classical approach and 77 to a transmuscular approach. The lenght of surgery, days with intravenous opioids treatment, rest for pain, hospitalization time and cost between both techiques were compared.

A remarkable reduction of surgical time, days of treatment wiht opioids and rest, and hospitalization time were observed with the patients subjeted to a transmuscular approach. As consequence, the healthcare costs with this technique was slightly lower.

The transmuscular approach is advantageous because the postoperative evolution of the patients are better wtihout increasing healthcare costs.

Key Words: lumbar arthodesis, minimal invation, transmuscular approach, lumbar listhesis, transpedicular screws.


  1. Centro Regional de Neurocirugía de Tacuarembó-Hospital Regional de Tacuarembó–ASSE