Review of Cortical Bone Trajectory: Evidence of a New Technique

Asian Spine Journal
Juan Delgado-FernandezRafael G Sola

Abstract

This article summarizes recent evidence on the cortical bone trajectory (CBT) obtained from published anatomical, biomechanical, and clinical studies. CBT was proposed by Santoni in 2009 as a new trajectory that can improve the fixation of pedicle screws in response to screw loosening in osteoporotic patients. Recently, research interest has been growing with increasing numbers of published series and frequent reports of new applications. We performed an online database search using the terms "cortical bone trajectory," "pedicle screw," "CBT spine," "CBT fixation," "MISS CBT," and "traditional trajectory." The search included the PubMed, Ovid MEDLINE, Cochrane, and Google Scholar databases, resulting in an analysis of 42 articles in total. These covered three aspects of CBT research: anatomical studies, biomechanical parameters, and clinical cases or series. Compared to the traditional trajectory, CBT improves pullout strength, provides greater stiffness in cephalocaudal and mediolateral loading, and shows superior resistance to flexion/extension; however, it is inferior in lateral bending and axial rotation. CBT seems to provide better immediate implant stability. In clinical studies, CBT has shown better perioperative results...Continue Reading

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Citations

Oct 16, 2019·Acta neurochirurgica·Juan Delgado-FernándezRafael García de Sola
Dec 2, 2020·Journal of Neurological Surgery. Part A, Central European Neurosurgery·Juan Delgado-FernándezR G Sola

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Methods Mentioned

BETA
pullout

Software Mentioned

Google Scholar
Ovid Medline

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