Internal Fixation of the Lumbar Spine with Pedicle Screw Plating

Roy-Camille, R; Saillant, G; Mazel, Christian

doi:10.1097/00003086-198602000-00003

Cited by 615 publications

(325 citation statements)

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“…Pedicle screw fixation gained popularity, and became widely used in the lumbar region in Europe during the 1970s, through the work of Roy-Camille et al [10]. The first anatomic work was done by Saillant on this subject [11].…”

Section: Discussionmentioning

confidence: 99%

“…Relevant studies present the potential risk of damaging the nerve roots, dural sac, vascular structures, and pleura as a major limitation of pedicle screw instrumentation in lumbar spine. Such injuries occur mainly because of the adjacent neural structures rather than the size of pedicle [5,6,8,10,11,12]. There are many clinical applications of lumbar transpedicular fixation.…”

Section: Discussionmentioning

confidence: 99%

“…Instrumentation techniques of the spine using the pedicle from posterior into the vertebral body have become popular recently, because of the advantages of these systems [1, 3,4,5,6,10,11,12,13]. Pedicle screw placement does not pose the same high risk of damage to the spinal cord, dural sac, and nerve roots in the lumbar region as it does in thoracic and cervical spine.…”

Section: Introductionmentioning

confidence: 99%

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Lumbar pedicle: surgical anatomic evaluation and relationships

Attar

Ugur

et al. 2001

European Spine Journal

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IntroductionTranspedicular screw fixation can be used for the treatment of unstable lumbar spine caused by trauma, tumors, infections, and degenerative conditions. Instrumentation techniques of the spine using the pedicle from posterior into the vertebral body have become popular recently, because of the advantages of these systems [1, 3,4,5,6,10,11,12,13]. Pedicle screw placement does not pose the same high risk of damage to the spinal cord, dural sac, and nerve roots in the lumbar region as it does in thoracic and cervical spine. However, accurate anatomic knowledge is needed to perform a safe surgical intervention in the lumbar region [2,9,11]. Despite the growing interest in pedicle instrumentation in the lumbar spine, the anatomic relationships of lumbar pedicle have not yet been analyzed adequately for the safe performance of these clinical applications. Even though some of the measurements duplicate previous studies, and the data presented in this study are limited to the surrounding tissues of the pedicle, we consider such that information is necessary for building Abstract Although several clinical applications of transpedicular screw fixation in the lumbar spine have been documented for many years, few anatomic studies concerning the lumbar pedicle and adjacent neural structures have been published. The lumbar pedicle and its relationships to adjacent neural structures were investigated through an anatomic study. Our objective is to highlight important considerations in performing transpedicular screw fixation in the lumbar spine. Twenty cadavers were used for observation of the lumbar pedicle and its relations. After removal of whole posterior bony elements including spinous processes, laminae, lateral masses, and inferior and superior facets, the isthmus of the pedicle was exposed. Pedicle width and height (PW and PH), interpedicular distance (IPD), pedicle-inferior nerve root distance (PIRD), pedicle-superior nerve root distance (PSRD), pedicle-dural sac distance (PDSD), root exit angle (REA), and nerve root diameter (NRD) were measured. The results indicated that the average distance from the lumbar pedicle to the adjacent nerve roots superiorly, inferiorly and to the dural sac medially at all levels ranged from 2.9 to 6.2 mm, 0.8 to 2.8 mm, and 0.9 to 2.1 mm, respectively. The mean PH and PW at L1-L5 ranged from 10.4 to 18.2 mm and 5.9 to 23.8 mm, respectively. The IPD gradually increased from L1 to L5. The mean REA increased consistently from 35°to 39°. The NRD was between 3.3 and 3.9 mm. Levels of significance were shown for the P<0.05 and P<0.01 levels. On the basis of this study, we can say that improper placement of the pedicle screw medially and inferiorly should be avoided.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Lumbar pedicle: surgical anatomic evaluation and relationships

Attar

Ugur

et al. 2001

European Spine Journal

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“…Despite substantial advances in infection control during the past 150 years [1,3], surgical site infections remain a major cause of morbidity and mortality [7,9,20]. Identification of surgical-site risk factors allows for implementation of more effective avoidance strategies [16].…”

Section: Introductionmentioning

confidence: 99%

“…Some authors have reported that the number of surgical site infections increase with operations lasting longer than 5 hours [9,10,21]. However, the increased rate of surgical site infections in longer cases historically has been attributed to higher blood loss, use of instrumentation, and more soft tissue injury [4,8,15,20]. To our knowledge, no one has questioned whether a surgeons' hands are a potential source of surgical site infection in longer operations ([ 3 hours).…”

Section: Introductionmentioning

confidence: 99%

Do Longer Surgical Procedures Result in Greater Contamination of Surgeons’ Hands?

Hosseini

Mundis

Eastlack

et al. 2016

Clinical Orthopaedics &Amp; Related Research

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Background A surgical site infection is a substantial cause of complications in patients. Different methods are being used to decrease surgical site infections; however, these infections still can cause complications, especially in patients undergoing longer operations ([ 3 hours). There is evidence that the efficacy of the scrubbing material fades after 3 hours. However, we do not know the longevity of hand cleanliness after application of scrubbing materials in a long operation. It can be postulated that if the surgeon's scrubbed hands are recolonized after a certain time, they may serve as a progressive source of contamination during surgery. Questions/purposes We asked: (1) Is there a correlation between surgical duration and hand contamination at the end of surgery? (2) At what point during surgery does hand contamination reach or exceed prescrub levels? Methods Three spine surgeons using the same scrubbing technique and materials consisting of chlorhexidine gluconate 1% solution and ethyl alcohol 61% w/w were enrolled in our study. Between December 2014 and April 2015, spine procedures of 3 hours or more, which were the One of the authors (PH) received funding from The San Diego Spine Foundation for this study. One of the authors certifies that he (BAA) or a member of his immediate family, has or may receive payments or benefits, during the study period, an amount of USD 10,000 to 100,000 from Nuvasive (San Diego, CA, USA), K2M (Leesburg, VA, USA), and DePuy Synthes (West Chester, PA, USA), and Ellipse (Aliso Viejo, CA, USA); an amount of USD 100,000 to 1000,000 from Nuvasive (San Diego, CA, USA); an amount of less than USD 10,000 from Ellipse (Aliso Viejo, CA, USA), Kspine (Leesburg, VA, USA), International Spine Study Group (Brighton, CO, USA), Nuvasive (San Diego, CA, USA), and K2M (Leesburg, VA, USA); Growing Spine Foundation (Milwaukee, WI, USA), San Diego Spine Foundation (San Diego, CA, USA), Scoliosis Research Society (Milwaukee, WI, USA), and Society of Lateral Access Surgery (San Diego, CA, USA). One of the authors certifies that he (GMM) or a member of his immediate family, has or may receive payments or benefits, during the study period, an amount of USD 100,000 to 1,000,000 from Nuvasive (San Diego, CA, USA); an amount of less than USD 10,000 from K2M (Leesburg, VA, USA), Medicrea (Lyon, France), Misonix (Farmingdale, NY, USA), International Spine Study Group Foundation (Brighton, CO, USA), Society of Lateral Access Surgery (San Diego, CA, USA), Scoliosis Research Society (Milwaukee, WI, USA), and San Diego Spine Foundation (San Diego, CA, USA). One of the authors certifies that he (RE) or a member of his immediate family, has or may receive payments or benefits, during the study period, an amount of less than USD10,000 from Globus Medical (Audubon, PA, USA), Aesculap/B. Braun (Center Valley, PA, USA), DePuy (West Chester, PA, USA), Johnson & Johnson Company (New Brunswick, NJ, USA), Eli Lilly (Indianapolis, IN, USA), Synthes (West Chester, PA, USA), DiFusion (Georgetown, TX, USA), Inv...

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