Percutaneous Pedicle Fixation

Percutaneous = a minimally invasive surgical approach using very small skin incisions
Pedicle  = a section of bone that connects the front and back of a vertebra (bone of the spine)
Fixation= the implantation of hardware such as screws and rods to hold vertebrae (bones of the spine) in place

Percutaneous pedicle fixation is a specific technique that surgeons can use to implant metal rods and screws that stabilize the spine. This technique may be used during a spinal fusion procedure.

Percutaneous pedicle fixation is performed without a traditional large incision. Instead, screws and rods are inserted through a few very small incisions. Using these small incisions, the surgeon implants screws into the pedicles, which are anatomic tubes of bone that connect the front and back of vertebrae. Rigid rods are inserted into special slots in the screw heads, connecting and immobilizing the vertebrae.

Percutaneous pedicle fixation is sometimes performed as part of a spinal fusion surgery, in which transplanted bone is used to encourage two or more vertebrae to unite into one bone for more stability in the spine.
Fusion and fixation may be performed to relieve pain caused by degenerative spinal conditions, to stabilize the spine after trauma, to treat instability due to tumor or infection or to correct a spinal deformity.

Percutaneous pedicle fixation is performed under general anesthesia, which means the patient is unconscious.

First, the surgeon makes tiny incisions on the patient’s back on either side of the spinal column. Next, the surgeon inserts screws guided by an X-ray technique called fluoroscopy or an intraoperative navigation system that relies on either X-ray or computed tomography (CT) images. New technology now offers robotic assistance to improve accuracy. Finally, rods are inserted into special slots at the screw heads and locked into place. The surgical instruments are then removed, and the incisions are closed with one or two sutures.

Make sure to tell your doctor about any medications that you’re taking, including over the counter medication and supplements, especially medications that can thin your blood such as aspirin. Your doctor may recommend you stop taking these medications before your procedure. To make it easier, write all of your medications down before the day of surgery.

Be sure to tell your doctor if you have an allergy to any medications, food, or latex (some surgical gloves are made of latex).

On the day of surgery, remove any nail polish or acrylic nails, do not wear makeup and remove all jewelry. If staying overnight, bring items that may be needed, such as a toothbrush, toothpaste, and dentures.

Percutaneous pedicle fixation is a technique that may be used during various procedures. For more information about what to expect after your procedure, visit one of the procedure pages below, or have a look at our list of surgical treatments.

Instrumented spinal fusion 

Minimally invasive spinal fusion 

Transforaminal interbody lumbar fusion (TLIF) 

Lateral lumbar interbody fusion (LLIF)

At the Spine Hospital at The Neurological Institute of New York, Drs. Paul C. McCormick, Michael G. Kaiser, Peter D. Angevine, Alfred T. Ogden, Christopher E. Mandigo and Patrick C. Reid are experts in percutaneous pedicle fixation.