Transdiscal screw fixation [Neurosurgery Wiki]

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=====Transdiscal screw fixation=====
Transdiscal fixation is defined as screw placement in the S1 pedicles, across the L5-S1 disc space, and penetrating into the L5 vertebral body. 

Collados-Maestre et al. hypothesized that the transdiscal fixation is mechanically stronger to resist L5-S1 slipping compared with pedicle fixation, regardless of the fixation level proximal to L5
((Collados-Maestre I, Lizaur-Utrilla A, Bas-Hermida T, Pastor-Fernandez E,
Gil-Guillen V. Transdiscal screw versus pedicle screw fixation for high-grade
L5-S1 isthmic spondylolisthesis in patients younger than 60 years: a case-control
study. Eur Spine J. 2016 Jun;25(6):1806-12. doi: 10.1007/s00586-016-4550-0. Epub 
2016 Apr 5. PubMed PMID: 27048540.
))

====Case series====

Many case-series studies of lumbosacral fusion for spondylolisthesis have been reported, but only a few have focused on L5-S1 [[transdiscal screw fixation]]s 
((Boachie-Adjei O, Do T, Rawlins BA (2002) Partial lumbosacral kyphosis reduction, decompression, and posterior lumbosacral transfixation in high-grade isthmic spondylolisthesis: clinical and radiographic results in six patients. Spine 27:161–168))
((Francois J, Lauweryns P, Fabry G (2005) Treatment of high- grade spondylolisthesis by posterior lumbosacral transfixation with transdiscal screws: surgical technique and preliminary results in four cases. Acta Orthop Belg 71:334–341))
((Logroscino CA, Tamburrelli FC, Scaramuzzo L, Schiro GR, Sessa S, Proietti L (2012) Transdiscal L5-S1 screws for the treatment of adult spondylolisthesis. Eur Spine J 21(Suppl 1):128–133)).
, and only 2 of these had more than 20 patients
((Rodriguez-Olaverri JC, Zimick NC, Merola A, Vicente J, Rodriguez J, Tabuenca A et al (2008) Comparing the clinical and radiological outcomes of pedicular transvertebral screw fixation of the lumbosacral spine in spondylolisthesis versus unilateral transforaminal lumbar interbody fusion (TLIF) with posterior fixation using anterior cages. Spine 33:1977–1981))
((Zagra A, Giudici F, Minoia L, Corriero AS, Zagra L (2009) Long-term results of pediculo-body fixation and posterolateral fusion for lumbar spondylolisthesis. Eur Spine J 18(Suppl 1):151–155)).

Other studies had used transdiscal screwing associated with some other technique of fusion
((Grob D, Humke T, Dvorak J (1996) Direct pediculo-body fixation in cases of spondylolisthesis with advanced intervertebral disc degeneration. Eur Spine J 5:281–285))
((Bartolozzi P, Sandri A, Cassini M, Ricci M (2003) One-stage posterior decompression-stabilization and trans-sacral interbody fusion after partial reduction for severe L5-S1 spondylolisthesis. Spine 28:1135–1141))
((Smith JA, Deviren V, Berven S, Kleinstueck F, Bradford DS (2001) Clinical outcome of trans-sacral interbody fusion after partial reduction for high-grade L5–S1 spondylolisthesis. Spine 26:2227–2234))
((Lakshmanan P, Ahuja S, Lewis M, Howes J, Davies PR (2009) Transsacral screw fixation for high-grade spondylolisthesis. Spine J 9:1024–1029)).

see also [[Pedicular transvertebral screw fixation]]