Perforation Rates of Cervical Pedicle Screw Insertion by Disease and Vertebral Level

Uehara, Mariko; Takahashi, J.; Hirabayashi, Hiroki; Hashidate, Hiroyuki; Ogihara, Nobuhide; Mukaiyama, Keijiro; Kato, Hiroyuki

doi:10.1016/j.spinee.2010.07.281

Cited by 5 publications

(3 citation statements)

References 13 publications

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“…A semi-hybrid surgical technique involving laminoplasty and internal screw fixation has been used to treat degenerative cervical diseases, including cervical spondylosis with kyphosis (18,19) and cervical spondylosis (or OPLL) combined with the presence of unstable segments (20,21). However, few reports on the use of this technique to treat traumatic cervical spinal cord injuries have been published (22-24).…”

Section: Discussionmentioning

confidence: 99%

Cervical single open-door laminoplasty with or without local lateral mass screw fixation and fusion to treat cervical spinal cord injuries accompanied by segmental spinal canal stenosis

Xie

Ouyang

et al. 2023

Front. Surg.

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Study DesignRetrospective.ObjectivesTo investigate the efficacy of cervical single open-door laminoplasty with and without local lateral mass screw fixation and fusion as treatments for cervical spinal cord injuries accompanied by multisegmental spinal canal stenosis.SettingThe Second Affiliated Hospital, School of Medicine, Zhejiang University.MethodsOf all enrolled patients, 42 formed a stable group who underwent cervical single open-door laminoplasty alone and 14 formed an unstable group who underwent the procedure combined with lateral mass screw fixation and fusion. Neurological function was evaluated before surgery, at discharge, and at final follow-up using the American Spinal Cord Injury Association (ASIA) impairment scale and the Japanese Orthopedic Association (JOA) score.ResultsASIA scores reflected improved neurological function in 52.5% of the stable group (15 with grade-D and 4 with grade-A injuries did not improve) and 45.5% of the unstable group (3 with grade-D and 3 with grade-A injuries did not improve). Postoperative JOA scores reflected 19.1% ± 21.6% improvement in the stable group and 18.6% ± 18.4% improvement in the unstable group (P > 0.05). Final follow-up JOA scores reflected 49.2% ± 31.7% improvement in the stable group and 47.1% ± 39.2% improvement in the unstable group (P > 0.05).ConclusionsLaminoplasty combined with local fusion aided the treatment of unstable cervical spinal cord injuries and spinal stenosis. Such stenosis is the main pathological factor causing multiple spinal cord compressions in patients with cervical spinal cord injuries.

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Section: Discussionmentioning

confidence: 99%

Cervical single open-door laminoplasty with or without local lateral mass screw fixation and fusion to treat cervical spinal cord injuries accompanied by segmental spinal canal stenosis

Xie

Ouyang

et al. 2023

Front. Surg.

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“…In the meta-analysis reported by Tian et al, the accuracy of pedicle screw insertion by CT navigation (90.76%) was significantly improved compared to the two-dimensional imaging system (85.48%) [16]. Our institution employs a CT-based navigation system for the cervical pedicle screw insertion [9][10][11][12]. The result of this paper was that the percentage of major perforations were 4.4%, total perforation rates were 17.9% for all cervical pedicle screws.…”

Section: Discussionmentioning

confidence: 90%

“…However, cervical pedicle screw insertion is technically demanding because of the narrow pedicle diameter and the risk of serious neurovascular complications including vertebral artery tear, spinal cord injury, and nerve root injury [7]. To achieve more accurate and safe pedicle screw insertion, navigation by two-dimensional imaging system or CT has been employed in recent years [9][10][11][12]. However, CPS insertion from C3 to C6 is technically demanding.…”

Section: Introductionmentioning

confidence: 99%

Perforation Rates of Cervical Pedicle Screw Inserted from C3 to C6 - A Retrospective Analysis of 78 Patients over a Period 5 of 14 Years -

Takahashi¹,

Hirabayashi²,

Hashidate³

et al. 2012

Spine Surgery

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The Surgical Treatment Principles of Atlantoaxial Instability Focusing on Rheumatoid Arthritis

Shih

Kao

Pan

et al. 2015

BioMed Research International

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Object. This retrospective review was conducted to determine the surgical treatment principle for rheumatoid arthritis (RA) patients with atlantoaxial instability (AAI). Methods. Thirteen patients with AAI, including 5 RA patients, received preoperative computed tomography- (CT-) based image-guided navigation system (IGS) in C1 lateral mass-C2 pedicle screw-rod system fixation (LC1-PC2 fixation). These 13 patients were analyzed for 52 screws inserted into C1 and C2. We defined these patients as non-RA group (8 patients, 32 screws) and RA group (5 patients, 20 screws). The neurological status for RA group was evaluated using the Ranawat classification. The causes of AAI, surgical indications, complications, surgical method revolution, and CT-based navigation application are discussed. Results. None of the 13 patients expressed neurological function deterioration. The non-RA group screw accuracy was 100%. In the RA group, 1 RA patient developed left C2 screw loosening at 1+ months after operation due to screw malposition. The screw accuracy for this group was 95%. Conclusions. Higher intraoperative surgical complication rate was described in RA patients. Preoperative CT-based IGS in LC1-PC2 fixation can provide good neurological function and screw accuracy results. However, for higher screw accuracy in RA patients, intraoperative CT-based IGS application may be considered.

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Perforation Rates of Cervical Pedicle Screw Insertion by Disease and Vertebral Level

Cited by 5 publications

References 13 publications

Cervical single open-door laminoplasty with or without local lateral mass screw fixation and fusion to treat cervical spinal cord injuries accompanied by segmental spinal canal stenosis

Cervical single open-door laminoplasty with or without local lateral mass screw fixation and fusion to treat cervical spinal cord injuries accompanied by segmental spinal canal stenosis

Perforation Rates of Cervical Pedicle Screw Inserted from C3 to C6 - A Retrospective Analysis of 78 Patients over a Period 5 of 14 Years -

The Surgical Treatment Principles of Atlantoaxial Instability Focusing on Rheumatoid Arthritis

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