การรักษาโรคหมอนรองกระดูกทับเส้นประสาทด้วยเทคนิค cortical screw

One of the most common concerns among patients undergoing spinal surgery is the fear of losing mobility after surgery. However, with the advancement of modern surgical techniques, spine surgery today is more precise, less invasive, and allows for a faster recovery. Among these innovations is the use of screw-based spinal fixation, which significantly reduces the risk of postoperative complications such as nerve injury, numbness, or impaired mobility.
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<h2>Role of Intervertebral Discs</h2>
Intervertebral discs act as shock absorbers between the bones of the spine. These discs enable smooth spinal movement and absorb pressure from daily activities. With aging or repetitive stress—such as poor posture, heavy lifting, or high-impact sports—discs can become degenerated, herniated, or displaced, resulting in nerve compression that may affect mobility, cause pain, or impair balance.
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<h2>Pedicular Screw Fixation: Traditional Approach</h2>
Traditionally, surgeons have used pedicular screws to stabilize the spine, especially in cases of spinal instability or vertebral slippage. These screws are inserted from the outside toward the center of the spine, requiring larger lateral incisions and exposure of soft tissue and bone, which may lead to greater blood loss and longer recovery.
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<h2>Cortical Screw: A New, Less Invasive Alternative</h2>
The cortical screw technique is a modern approach designed to overcome the limitations of traditional pedicular screws. Cortical screws are smaller in size but offer 1.5 times greater strength, and they are inserted from the inside out, allowing the use of a single midline incision.
This technique avoids additional incisions by using the same access point created during nerve decompression surgery. During the procedure, the surgeon performs facet joint fusion—a stabilizing technique at the back of the spine—while applying bone graft materials such as Demineralized Bone Matrix (DBM) to promote bone healing, reduce bleeding, and protect surrounding tissues and nerves.
<h3>Advantages of Cortical Screw Technique</h3>
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<li style="font-weight: 400;" aria-level="1">Smaller incision and minimal soft tissue disruption 
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<li style="font-weight: 400;" aria-level="1">Less postoperative pain and reduced bleeding 
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<li style="font-weight: 400;" aria-level="1">Shorter recovery time 
</li>
<li style="font-weight: 400;" aria-level="1">Ideal for elderly patients or those with low bone density 
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<li style="font-weight: 400;" aria-level="1">High-strength fixation with minimal impact on surrounding structures 
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</ul>
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<h2>Limitations and Patient Selection</h2>
While the cortical screw technique is suitable for most age groups, it is not recommended for patients with:
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<li style="font-weight: 400;" aria-level="1">Severe spinal deformities 
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<li style="font-weight: 400;" aria-level="1">Vertebral slippage exceeding 50% 
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</ul>
In such cases, pedicular screws are still preferred due to their greater pull-out strength.
Additionally, in the context of herniated disc surgery, cortical screws are often used in conjunction with facet fusion techniques and do not require disc replacement, which differentiates this method from other fusion approaches.
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<h2>Recognizing Spinal Compression Symptoms</h2>
Spinal nerve compression is a growing concern in modern populations, often caused by age, lifestyle, or trauma. Patients should remain alert for symptoms such as:
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<li style="font-weight: 400;" aria-level="1">Numbness or tingling in the legs 
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<li style="font-weight: 400;" aria-level="1">Radiating pain from the lower back to the legs 
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<li style="font-weight: 400;" aria-level="1">Difficulty walking or decreased mobility 
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</ul>
Early diagnosis and consultation with a spine specialist are essential for effective and timely treatment.

One of the most common concerns among patients undergoing spinal surgery is the fear of losing mobility after surgery. However, with the advancement of modern surgical techniques, spine surgery today is more precise, less invasive, and allows for a faster recovery.

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Treating Herniated Disc with Cortical Screw Technique: A Minimally Invasive Advancement

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