International Clinical Neuroscience Journal

Vol. 1 No. 2 (2014)

Accuracy and complications of pedicle screw insertion for lumbar and thoracolumbar fractures

International Clinical Neuroscience Journal, Vol. 1 No. 2 (2014), 25 November 2014 , Page 61-64
https://doi.org/10.22037/icnj.v1i2.7245

Abstract

 

Background: The accuracy of pedicle screw placement is essential for lumbar and thoracolumbar spine fracture fixation.

Purpose: The aim of the present study was to assess the accuracy of the pedicle screw placement with conventional C-arm fuoroscopy-guided in these patients.

Methods: A retrospective review identified patients who underwent operative management with thoracolumbar instruments at our hospital between June 2012 and August 2013. Clinical data were acquired from medical records and final screw positions were graded based on a classification of Gertzbein and Robbins.

Results: A total of 216 pedicle screws in 52 patients (34 males, mean age 32.6±5.8 years) were evaluated. They were instrumented with transpedicular posterior fixation technique within 72 hours. The follow-up time was 6.1 months (ranging from 1 to 14 months). The screws were graded A (n=43 [19.9%]), B (n=89 [41.2%]), C (n=62 [28.7%]), D (n=21 [9.7%]), and E (n=1 [0.5%]). One of the screws was revised on the second day after surgery due to screw malposition.

Conclusion: Based on existing facilities, the findings showed that the pedicle instrumentation screws with transpedicular posterior fixation technique in patients with lumbar and thoracolumbar fractures can be done with acceptable complication rate. However, more advanced equipment as CT navigation (O-arm) is recommended for higher accuracy.

Keywords:
  • Lumbar and thoracolumbar fracture
  • spine instrumentation
  • accuracy
  • pedicle screw placement

How to Cite

1.
Azimi P, Shahzadi S, Shahzadi A. Accuracy and complications of pedicle screw insertion for lumbar and thoracolumbar fractures. Int Clin Neurosci J [Internet]. 2014 Nov. 25 [cited 2023 Dec. 3];1(2):61-4. Available from: https://journals.sbmu.ac.ir/neuroscience/article/view/7245

References

Gaines RW Jr. The use of pedicle-screw internal fixation for the operative treatment of spinal disorders. J Bone Joint Surg Am. 2000;82-A(10):1458-76.

Manbachi A, Cobbold RS2, Ginsberg HJ3.Guided pedicle screw insertion: techniques and training. Spine J. 2014;14(1):165-79.

Fan Chiang CY, Tsai TT, Chen LH, Lai PL, Fu TS, Niu CC, et al.Computed tomography-based navigation-assisted pedicle screw insertion for thoracic and lumbar spine fractures. Chang Gung Med J. 2012;35(4):332-8.

Schatlo B, Molliqaj G, Cuvinciuc V, Kotowski M, Schaller K, Tessitore E. Safety and accuracy of robot-assisted versus fluoroscopy-guided pedicle screw insertion for degenerative diseases of the lumbar spine: a matched cohort comparison. J Neurosurg Spine. 2014;20(6):636-43.

Gertzbein SD, Robbins SE. Accuracy of pedicular screw placement in vivo. Spine (Phila Pa 1976). 1990;15:11-14.

Heini P, Scholl E, Wyler D, Eggli S. Fatal cardiac tamponade associated with posterior spinal instrumentation. A case report. Spine (Phila Pa 1976). 1998;23:2226-30.

Laine T, Lund T, Ylikoski M, Lohikoski J, Schlenzka D. Accuracy of pedicle screw insertion with and without computer assistance: a randomised controlled clinical study in 100 consecutive patients. Eur Spine J. 2000;9:235-40.

Amiot LP, Lang K, Putzier M, Zippel H, Labelle H. Comparative results between conventional and computer-assisted pedicle screw installation in the thoracic, lumbar, and sacral spine. Spine (Phila Pa 1976). 2000;25:606-14.

Merloz P, Tonetti J, Pittet L, Coulomb M, Lavallee S, Sautot P. Pedicle screw placement using image guided techniques. Clin Orthop Relat Res. 1998;354:39-48.

Schwarzenbach O, Berlemann U, Jost B, Visarius H, Arm E, Langlotz F, Nolte LP, Ozdoba C. Accuracy of computer-assisted pedicle screw placement. An in vivo computed tomography analysis. Spine (Phila Pa 1976). 1997;22:452-8.

Kotani Y, Abumi K, Ito M, Minami A. Improved accuracy of computer-assisted cervical pedicle screw insertion. J Neurosurg 2003;99:257-63.

Kotani Y, Abumi K, Ito M, Takahata M, Sudo H, Ohshima S, et al. Accuracy analysis of pedicle screw placement in posterior scoliosis surgery: comparison between conventional fluoroscopic and computer-assisted technique. Spine (Phila Pa 1976). 2007;32:1543-50.

Youkilis AS, Quint DJ, McGillicuddy JE, Papadopoulos SM. Stereotactic navigation for placement of pedicle screws in the thoracic spine. Neurosurgery. 2001;48:771-8.

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