Safety and Efficacy in Pain Reduction of CT-Guided Screw Fixation for Post-laminectomy Surgery Segment Spinal Instability: A Monocentric Study of 24 Patients (2023-2026)

Post Laminectomy Spinal Instability: the Role of CT Guided Screw Fixation to Avoid New Surgery

Segmental instability of the spine following laminectomy or surgical arthrodesis is a common complication that often requires additional surgical intervention. CT-guided trans-facet screw fixation (TFF), performed under local anesthesia, is an innovative and minimally invasive technique that offers an alternative to open surgery under general anesthesia. This study aims to evaluate the effectiveness of CT-guided TFF fixation in reducing pain and improving daily activities in a population of 24 patients who have undergone prior spinal surgeries

Inclusion Criteria:

• Treated at the University Hospital of Nice between march 2023 and january 2026 with trans-facet arthrodesis for persistent lumbar segment instability following previous laminectomy surgery.
• MRI or scintigraphy imaging showed signs suggestive of instability
• Newly developed or worsening spondylolisthesis on successive examinations
• Congestive arthropathy
• Facet dislocation
• Inflammatory disc disease (MODIC type 1 changes)

Exclusion Criteria:

• Inability to tolerate the prone position under local anesthesia.
• Presence of anatomical variants precluding the technical feasibility of transfacet fixation.