542 - Instrumentation of the Spine: From Wires to Pedicle Screws...

#542 Instrumentation of the Spine: From Wires to Pedicle Screws

Lumbar Therapies and Outcomes

Poster Presented by: D. Malhotra


D. Malhotra (1)
S. Kalb (2)
N. Rodriguez-Martinez (1)
D.D. Hem (1)
H. Soriano-Baron (1)
L. Perez-Orribo (1)
N.R. Crawford (1)
V.K.H. Sonntag (2)

(1) Barrow Neurological Institute, Spinal Biomechanics Laboratory, Phoenix, AZ, United States
(2) Barrow Neurological Institute, Division of Neurological Surgery, Phoenix, AZ, United States


Introduction: Over the course of the last 120 years, spinal stabilization has advanced immensely. An updated review highlighting these advancements has not been written in the past 20 years. The objective of this report is to provide the reader with an historical assessment of the decades outlining various key innovators, their techniques, and instrumentation.

Methods: Research concerning spinal instrumentation, techniques, and outcomes for stabilization was reviewed and summarized from pre-1900 to current literature using search engines such as Pubmed, in addition to in-house journals.

Results: Beginning with Hadra's use of wires to treat fractures in 1891, placing facet screws described by Toumey and King in the 1940s, inserting pedicle screws in the 1960s by Harrington, using plates in the 1970s by Roy-Camille, incorporating rods and hooks by Cotrel and Dubousset in the 1980s, to current standards such as top-loading pedicle screw systems, it is clear that the evolution of spinal instrumentation is one that is extensive and noteworthy. This is evidenced by milder patient rehabilitation methods and decreased recovery time when comparing current outcomes to those over a century ago.

Discussion: The use of pedicle screws may be one of the most important advancements in spinal surgery due to the dramatic change in patient outcomes after their introduction. For this reason, it is important to present new and upcoming generations of surgeons and students with historical evidence of the value of developing new techniques and instrumentation on behalf of patient care and outcomes.