scholarly journals Cortical Bone Trajectory for Lumbar Pedicle Screw Placement: A Review of Published Reports

2015 ◽  
Vol 7 (3) ◽  
pp. 213-221 ◽  
Author(s):  
Kevin Phan ◽  
Jarred Hogan ◽  
Monish Maharaj ◽  
Ralph J Mobbs
Keyword(s):  
Cortical Bone ◽  
Pedicle Screw ◽  
Screw Placement ◽  
Pedicle Screw Placement ◽  
Cortical Bone Trajectory ◽  
Lumbar Pedicle

scholarly journals Confirmation of accuracy/inaccuracy of lumbar pedicle screw placement using postoperative computed tomography

2021 ◽  
Vol 12 ◽  
pp. 518
Author(s):  
Mohamed M. Arnaout ◽  
Magdy O. ElSheikh ◽  
Mansour A. Makia
Keyword(s):  
Computed Tomography ◽  
Lumbar Spine ◽  
Pedicle Screw ◽  
Pedicle Screws ◽  
Operative Intervention ◽  
Screw Placement ◽  
Lumbar Spine Surgery ◽  
Pedicle Screw Placement ◽  
Lumbar Pedicle ◽  
Ct Studies

Background: Transpedicular screws are extensively utilized in lumbar spine surgery. The placement of these screws is typically guided by anatomical landmarks and intraoperative fluoroscopy. Here, we utilized 2-week postoperative computed tomography (CT) studies to confirm the accuracy/inaccuracy of lumbar pedicle screw placement in 145 patients and correlated these findings with clinical outcomes. Methods: Over 6 months, we prospectively evaluated the location of 612 pedicle screws placed in 145 patients undergoing instrumented lumbar fusions addressing diverse pathology with instability. Routine anteroposterior and lateral plain radiographs were obtained 48 h after the surgery, while CT scans were obtained at 2 postoperative weeks (i.e., ideally these should have been performed intraoperatively or within 24–48 h of surgery). Results: Of the 612 screws, minor misplacement of screws (≤2 mm) was seen in 104 patients, moderate misplacement in 34 patients (2–4 mm), and severe misplacement in 7 patients (>4 mm). Notably, all the latter 7 (4.8% of the 145) patients required repeated operative intervention. Conclusion: Transpedicular screw insertion in the lumbar spine carries the risks of pedicle medial/lateral violation that is best confirmed on CT rather than X-rays/fluoroscopy alone. Here, we additional found 7 patients (4.8%) who with severe medial/lateral pedicle breach who warranting repeated operative intervention. In the future, CT studies should be performed intraoperatively or within 24–48 h of surgery to confirm the location of pedicle screws and rule in our out medial or lateral pedicle breaches.

806 Virtual Fluoroscopy Improves Lumbar Pedicle Screw Placement Accuracy

Neurosurgery ◽  
2000 ◽  
Vol 47 (2) ◽  
pp. 530-530 ◽  
Author(s):  
Kevin T. Foley ◽  
Ramesh L. Sahjpaul ◽  
Gerald R. Rodts
Keyword(s):  
Pedicle Screw ◽  
Screw Placement ◽  
Pedicle Screw Placement ◽  
Placement Accuracy ◽  
Lumbar Pedicle

Accuracy of percutaneous lumbar pedicle screw placement using the oblique or “owl's-eye” view and novel guidance technology

2010 ◽  
Vol 13 (4) ◽  
pp. 509-515 ◽  
Author(s):  
Cary Idler ◽  
Kevin W. Rolfe ◽  
Josef E. Gorek
Keyword(s):  
Pedicle Screw ◽  
Facet Joint ◽  
Pedicle Screws ◽  
Guidance System ◽  
Screw Placement ◽  
Pedicle Screw Placement ◽  
Screw Insertion ◽  
Percutaneous Pedicle Screw ◽  
Clinical Series ◽  
Lumbar Pedicle

Object This study was conducted to assess the in vivo safety and accuracy of percutaneous lumbar pedicle screw placement using the owl's-eye view of the pedicle axis and a new guidance technology system that facilitates orientation of the C-arm into the appropriate fluoroscopic view and the pedicle cannulation tool in the corresponding trajectory. Methods A total of 326 percutaneous pedicle screws were placed from L-3 to S-1 in 85 consecutive adult patients. Placement was performed using simple coaxial imaging of the pedicle with the owl's-eye fluoroscopic view. NeuroVision, a new guidance system using accelerometer technology, helped align the C-arm trajectory into the owl's-eye view and the cannulation tool in the same trajectory. Postoperative fine-cut CT scans were acquired to assess screw position. Medical records were reviewed for complications. Results Five of 326 screws breached a pedicle cortex—all breaches were less than 2 mm—for an accuracy rate of 98.47%. Five screws violated an adjacent facet joint. All were at the S-1 superior facet and included in a fusion. No screw violated an adjacent mobile facet or disc space. There were no cases of new or worsening neurological symptoms or deficits for an overall clinical accuracy of 100%. Conclusions The owl's-eye technique of coaxial pedicle imaging with the C-arm fluoroscopy, facilitated by NeuroVision, is a safe and accurate means by which to place percutaneous pedicle screws for degenerative conditions of the lumbar spine. This is the largest series reported to use the oblique or owl's-eye projection for percutaneous pedicle screw insertion. The accuracy of percutaneous screw insertion with this technique meets or exceeds that of other reported clinical series or techniques.

Joint kinematics of surgeons during lumbar pedicle screw placement

2015 ◽  
Vol 12 (4) ◽  
pp. 701-709
Author(s):  
Jeong-Yoon Park ◽  
Kyung-Hyun Kim ◽  
Sung-Uk Kuh ◽  
Dong-Kyu Chin ◽  
Keun-Su Kim ◽  
...  
Keyword(s):  
Pedicle Screw ◽  
Joint Kinematics ◽  
Screw Placement ◽  
Pedicle Screw Placement ◽  
Lumbar Pedicle

Morphometric Measurement of Cortical Bone Trajectory for Lumbar Pedicle Screw Insertion Using Computed Tomography

2013 ◽  
Vol 26 (6) ◽  
pp. E248-E253 ◽  
Author(s):  
Keitaro Matsukawa ◽  
Yoshiyuki Yato ◽  
Osamu Nemoto ◽  
Hideaki Imabayashi ◽  
Takashi Asazuma ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Cortical Bone ◽  
Pedicle Screw ◽  
Morphometric Measurement ◽  
Cortical Bone Trajectory ◽  
Screw Insertion ◽  
Pedicle Screw Insertion ◽  
Lumbar Pedicle
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