Spontaneous effect of increased stability of the lower lumbar spine in cases of severe chronic back pain. The answer of an external transpeduncular fixation test.

Eighteen patients with severe low-back pain of long duration were externally stabilized over selected segments of the lumbar spine to evaluate the pain relieving effect of increased stability. Five millimeter Schantz screws were driven into the vertebral body transpeduncularly by a closed technique using an image intensifier. A modified Hoffmann fixation device with possibilities to compress and distract was used for external stabilization. The results were recorded by means of pain area sketches and pain lines. All but one patient experienced remarkable relief of low-back pain and often of pain radiating into the lower extremities. No serious complications were seen. Of eight patients with residual severe pain after fusions, five were considered healed using radiologic techniques and three were improved by external stabilization. This test could be used to identify candidates, select levels for lumbar fusion, and evaluate the stability of previous fusions.