Potential Large Vessel Injury During Thoracolumbar Pedicle Screw Removal

Vanichkachorn, Jed S.; Vaccaro, Alexander R.; Cohen, Murray; Cotler, Jerome M.

doi:10.1097/00007632-199701010-00018

Cited by 71 publications

(44 citation statements)

References 9 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Although the rate of neurovascular complications associated with screw misplacement in scoliosis surgery usually reported to be almost 0% [3,[5][6][7], reports on serious complications associated with screw misplacement have been published since the introduction of this procedure [8][9][10][11]. As segmental pedicle screw fixation has become a widely used method in scoliosis corrective surgery, the knowledge about the pedicle morphometry has become increasingly essential.…”

Section: Introductionmentioning

confidence: 99%

Patients with adolescent idiopathic scoliosis of Lenke type-1 curve exhibit specific pedicle width pattern

Abul-Kasim

Ohlin

2011

Eur Spine J

View full text Add to dashboard Cite

Introduction Study aim was to find out if patients with Lenke type 1 curve exhibit smaller pedicles and specific pedicle width pattern compared with individuals with no scoliosis. Materials and methods 4,828 pedicle width measurements (T1-L5) in 61 consecutive patients with adolescent idiopathic scoliosis of Lenke type 1 curve, 61 control subjects, and 20 patients with Lenke type 5 curve, were retrospectively performed by an experienced neuroradiologist. Results Among patients with Lenke type 1 curve, the differences between the width of right and left upper thoracic pedicles were statistically significant; smallest at right T4 (2.6 mm). At scoliotic apex, the pedicles on the concave (left) side were significantly smaller than those on the convex (right) side; smallest at left T7 (3.2 mm). Among patients with Lenke type 1 curve, 97% had pedicle width \4 mm. Conclusions Our study showed that patients with Lenke type 1 curve exhibit smaller pedicles and asymmetric pedicle width compared with control subjects.

show abstract

Section: Introductionmentioning

confidence: 99%

Patients with adolescent idiopathic scoliosis of Lenke type-1 curve exhibit specific pedicle width pattern

Abul-Kasim

Ohlin

2011

Eur Spine J

View full text Add to dashboard Cite

show abstract

“…The L4 roots are in the lateral part of the vertebral body and a screw which is at least 45 mm long and it is not introduced with an angle in the inferior part of the pedicle could break the lateral cortical and come into contact with the L4 root and damage it. Jendrisak 15 reported a case of spontaneous rupture of the aorta because of an anterior implant and Vanichkachorn et al 16 reported a case of an implant removal because of the implant protrusion which affected the aorta. Lim et al 17 reported a case of pseudoanaeurism of the aorta after an instrumentation with pedicular screws in T12 and L3.…”

Section: Discussionmentioning

confidence: 99%

Does the Shape of the L5 Vertebral Body Depend on the Height of CT Slices in the Pedicle?

Alfonso¹,

Palacio²,

Bastarrika³

et al. 2008

Spine

View full text Add to dashboard Cite

Study Design: The shape of the L5 vertebral body was analyzed using a computerized tomography (CT) scan. Objective: The aim of this study is to determine if the vertebral L5 body shape varies depending on the height of the CT slices through the L5 pedicle. Summary of Background Data: The morphometry of L5 has been studied to help the introduction of pedicular screws. The shape of the vertebral body has been seldom looked into, and the findings obtained show a triangular shape and hemispherical shape, supposedly owing to interpersonal variability. The hemisphere shape enables pedicular screws to be introduced nonconvergently, whereas the triangular shape enables pedicular screws to be introduced at a convergent angle but posing the risk of cortical perforation unless these guidelines are followed. Methods: Abdominal CT multicut with 64 crowns was performed in 101 consecutive patients with diverse indications. Width of CT slices was with a 1-mm reconstruction increase. We selected one axial slice that passed through the upper part of the pedicle and another one that passed through the lower part of the pedicle and compared next parameters in both cuts: pedicular cortical width, pedicular endostal width, pedicular angle, vertebral body length, vertebral body width, vertebral perimeter angles, and visual appearance of vertebral body shape. Results: We found statistical differences between all values except the anterior vertebral perimeter angle on comparing values of upper part with values of lower part and visual vertebral body shape was different in 93% of vertebrae. In the upper part the vertebral body is hemispherical whereas in the lower part it is triangular. Conclusion: In most cases, the vertebral body shape is hemispherical in the upper part of the pedicle and triangular in the lower part of the pedicle. It means that in the lower part pedicular screws must be introduced at a more convergent angle than in the upper part if we do not want to break any cortical of the vertebral body.

show abstract

“…Numerous papers have reported on the hazards and potential complications associated with pedicle screw insertions, but complications in conjunction with implant removal are rarely reported [13]. Vanichkachorn et al [13] report one case of potential large vessel injury during the removal of a broken pedicle screw. They conclude that routine removal of pedicle screws, especially screw fragments is not indicated and may result in rare but significant complications.…”

Section: Discussionmentioning

confidence: 99%

“…The risks associated with the use of pedicle screws, such as neurological problems, dural laceration, screw and rod breakage, screw loosening, and loss of correction due to implant failure, are well established and have been extensively reviewed [1,7,14]. However, there is a paucity of reports on the complication potential of implant removal of pedicle screw systems [13].…”

Section: Introductionmentioning

confidence: 99%

Vertebral body compression fracture after removal of pedicle screws: a report of two cases

Waelchli

Min

Cathrein

et al. 2002

European Spine Journal

View full text Add to dashboard Cite

Potential Large Vessel Injury During Thoracolumbar Pedicle Screw Removal

Cited by 71 publications

References 9 publications

Patients with adolescent idiopathic scoliosis of Lenke type-1 curve exhibit specific pedicle width pattern

Patients with adolescent idiopathic scoliosis of Lenke type-1 curve exhibit specific pedicle width pattern

Does the Shape of the L5 Vertebral Body Depend on the Height of CT Slices in the Pedicle?

Vertebral body compression fracture after removal of pedicle screws: a report of two cases

Contact Info

Product

Resources

About