Procedure

Percutaneous Pedicle Screw Fixation

Percutaneous pedicle screw fixation achieves rigid spinal stabilisation through 18 mm incisions — one per screw — eliminating the open muscle stripping of conventional posterior spinal fixation.

Book Consultation

All Procedures

Overview

About This Procedure

Pedicle screw fixation is the cornerstone of spinal stabilisation surgery. The percutaneous technique introduces screws through the pedicles — the strongest part of the vertebra — via small stab incisions under fluoroscopic or O-arm navigation, without exposing the spine. This preserves the posterior spinal musculature that is responsible for trunk extension strength and long-term functional outcomes. Rods are then passed through the screw tulips subcutaneously, creating a rigid construct. Percutaneous fixation is used for fractures, spondylolisthesis, fusion augmentation, and adjacent segment disease. Dr. Sparsh Jaiswal utilises both fluoroscopic and O-arm 3D navigation for percutaneous screw placement, achieving < 2% malposition rates.

Indications

check_circleTraumatic lumbar fractures requiring stabilisation without laminectomy
check_circleLumbar spondylolisthesis requiring posterior fixation
check_circleSupplement to interbody fusion procedures (MIS-TLIF)
check_circleSpinal tumour stabilisation after vertebrectomy
check_circleAdjacent segment disease after prior fusion requiring extension

Step-by-Step Procedure

Image-Guided Planning

Fluoroscopic or O-arm CT imaging establishes the precise trajectory for each screw. Navigation arrays or anatomical landmarks guide entry points.

Percutaneous Entry

A Jamshidi needle is advanced through a 5 mm stab incision to the pedicle entry point under lateral and AP fluoroscopic guidance. Position confirmed.

Sequential Screw Insertion

A guide wire is placed, the pedicle is tapped, and the screw is advanced over the wire. The process is repeated for all planned levels (typically 4–6 screws).

Rod Passage & Final Tightening

A connecting rod is passed through the screw heads percutaneously and locked. Compression or distraction applied as required. Final fluoroscopic check confirms construct.

info

What to Expect

Surgery takes 60–90 minutes for a 2-level construct. Patients mobilise within 24 hours. Incisions are small (four to six 18 mm wounds). Mild back soreness from screw tracks settles in 1–2 weeks.

healing

Recovery

Hospital stay is 2–3 days. Lumbar support for 4–6 weeks. Driving in 3–4 weeks. Return to desk work in 2–3 weeks; manual labour in 6–8 weeks. Hardware removal is rarely necessary.