{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T04:16:04Z","timestamp":1792642564338,"version":"4.5.0"},"reference-count":13,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2022,8,7]],"date-time":"2022-08-07T00:00:00Z","timestamp":1659830400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) using the SEXTANT\u00ae system (Medtronic) featured the first generation of commercially available percutaneous pedicle screw (PPS) system in 2001. The innovative system has since become standard instrumentation used worldwide, and PPS is now used for long-segment minimally invasive surgery (MIS) spinal fixation from the thoracic spine to the pelvis for pathological conditions. PPS systems have been developed for approximately 20 years for the purpose of improving minimally invasive techniques, safety of instrumentation, and ease of use. The third-generation PPS systems established the insertion technique, and the development of the fourth-generation PPS systems have made great strides in minimizing the number of steps in the operative procedure. In the future, PPS systems are expected to continue making use of the latest technological advancements and to develop further with the aim of ensuring greater safety, reducing operator stress, and preventing complications such as insertion errors and infection. In this review article, we describe the historical evolution from the first-generation PPS system to the current PPS systems used today.<\/jats:p>","DOI":"10.3390\/medicina58081064","type":"journal-article","created":{"date-parts":[[2022,8,8]],"date-time":"2022-08-08T22:33:11Z","timestamp":1659997991000},"page":"1064","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":20,"title":["The History and Development of the Percutaneous Pedicle Screw (PPS) System"],"prefix":"10.3390","volume":"58","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0094-7918","authenticated-orcid":false,"given":"Ken","family":"Ishii","sequence":"first","affiliation":[{"name":"Department of Orthopaedic Surgery, School of Medicine, International University of Health and Welfare (IUHW), Chiba 286-8686, Japan"},{"name":"Spine and Spinal Cord Center and Department of Orthopaedic Surgery, International University of Health and Welfare (IUHW) Mita Hospital, Tokyo 108-8329, Japan"},{"name":"Department of Orthopaedic Surgery, International University of Health and Welfare (IUHW) Narita Hospital, Chiba 286-8520, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8192-8342","authenticated-orcid":false,"given":"Haruki","family":"Funao","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, School of Medicine, International University of Health and Welfare (IUHW), Chiba 286-8686, Japan"},{"name":"Spine and Spinal Cord Center and Department of Orthopaedic Surgery, International University of Health and Welfare (IUHW) Mita Hospital, Tokyo 108-8329, Japan"},{"name":"Department of Orthopaedic Surgery, International University of Health and Welfare (IUHW) Narita Hospital, Chiba 286-8520, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9365-530X","authenticated-orcid":false,"given":"Norihiro","family":"Isogai","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, School of Medicine, International University of Health and Welfare (IUHW), Chiba 286-8686, Japan"},{"name":"Spine and Spinal Cord Center and Department of Orthopaedic Surgery, International University of Health and Welfare (IUHW) Mita Hospital, Tokyo 108-8329, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takanori","family":"Saito","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Kansai Medical University, Osaka 573-1191, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takeshi","family":"Arizono","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Kyushu Central Hospital, Fukuoka 815-8588, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masahiro","family":"Hoshino","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Sonoda Medical Institute Tokyo Spine Center, Tokyo 121-0807, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Koji","family":"Sato","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Japanese Red Cross Aichi Medical Center Nagoya Daini Hospital, Nagoya 466-8650, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,8,7]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Magerl, F. (1982). External Skeletal Fixation of the Lower Thoracic and the Lumbar Spine, Springer.","DOI":"10.1007\/978-3-642-68448-7_40"},{"key":"ref_2","first-page":"496","article-title":"Endoscopy assisted percutaneous anterior interbody fusion with subcutaneous suprafascial internal fixation: Evolution, techniques, and surgical considerations","volume":"3","author":"Mathews","year":"1995","journal-title":"Orthop. Int. Ed."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"E10","DOI":"10.3171\/foc.2001.10.4.11","article-title":"Percutaneous pedicle screw fixation of the lumbar spine","volume":"10","author":"Foley","year":"2001","journal-title":"Neurosurg. Focus."},{"key":"ref_4","first-page":"361","article-title":"Surgical technique of minimally invasive transforaminal interbody fusion (MIS-TLIF)","volume":"2","author":"Ishii","year":"2012","journal-title":"Bone Jt. 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A new technique useful for lumbosacral percutaneous pedicle screw placement without fluoroscopy or computer-aided navigation systems, J. Orthop. Sci., in press."}],"container-title":["Medicina"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1648-9144\/58\/8\/1064\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T00:05:22Z","timestamp":1760141122000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1648-9144\/58\/8\/1064"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,8,7]]},"references-count":13,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2022,8]]}},"alternative-id":["medicina58081064"],"URL":"https:\/\/doi.org\/10.3390\/medicina58081064","relation":{},"ISSN":["1648-9144"],"issn-type":[{"value":"1648-9144","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,8,7]]}}}