Role of postoperative multislice computed tomography in assessment of pedicle screw placement in spinal surgical fixation

Fiki, Inas M. El; Zaiton, Fatma; Awadalla, Akram

doi:10.1016/j.ejrnm.2012.12.003

Cited by 3 publications

(9 citation statements)

References 31 publications

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“…In our study, the rate of lateral violation was (57.41%) more than the medial one (20.37%). Our results agree with many authors [5,21,29,31] who reported a higher rate of lateral violation, and this is because the surgeons choose a more lateral track away from the more dense medial cortical wall of the pedicle and also to avoid spinal cord injury. In this study, pedicle penetration was more frequently in lateral and medial walls and less in inferior (12.96%) and superior ones (9.26%).…”

Section: Discussionsupporting

confidence: 93%

“…This was because of the pedicle anatomy [32]. These results were in accordance with that shown by previous studies [1,19,21,33].…”

Section: Discussionsupporting

confidence: 93%

“…In our study, we included all grades of displacement even those with <2 mm in the total rate of screw displacement. Elyan et al [20] and El Fiki et al [21] reported screws displacement rates of 17.3% and 16.45%, respectively, which were similar to that found in our study.…”

Section: Discussionsupporting

confidence: 91%

“…In our study, the rate of screw displacement was higher in dorsal pedicles (31.4%) as compared with that in the lumbo-sacral ones (11.9%). This could be explained by the small size of pedicles in the dorsal spines and increasing variability in their anatomy [11,21,24,28]. This was in accordance with previous studies [19,21,29,30] that reported a higher rate of screw displacement in dorsal than lumbar spines.…”

Section: Discussionsupporting

confidence: 85%

“…In our study, we reported neurologic sequels in seven of patients (10%). This was within the range reported in previous studies (0.2% to 11%) [21,34]. While our results were less than that reported by Lotfnia et al [31] (15.09%), the higher incidence in the later study might be due to the involvement of all patients with sensory or motor symptoms in spite of the existence or absence of neurological deficits.…”

Section: Discussionsupporting

confidence: 82%

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Postoperative 320 multi-slice computed tomography in assessment of pedicle screw insertion in thoraco-lumbar fixation

Salama

Amin

Soliman

et al. 2019

Egypt J Radiol Nucl Med

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Background: Pedicle screw instrumentation is used widely in lumbar spine for stabilization to enhance arthrodesis and has been accepted in the thoracic spine in recent years. The purpose of this study was to assess the value of postoperative 320 multi-slice computed tomography (MSCT) in assessment of pedicle screw placement in patients with spinal fixation with clinical and surgical correlation. Results: A total of 340 pedicular screws were inserted to 70 cases. 286 (84.12%) were in, 54 screws (15.88%) were violated, and revision surgeries were required for 5 displaced screws. On axial, coronal reconstruction and threedimensional (3D) reformatted CT images 36, 47, and 54 displaced screws were detected, respectively. Both sensitivity and specificity for 3D reformatted images were 100%. For axial image, they were 97.6% and 89.4%, respectively, compared with surgical findings in 5 revised screws. Conclusion: Multi-slice CT scan is a valuable and valid postoperative assessment tool of accuracy of spinal pedicle screw placement.

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Section: Discussionsupporting

confidence: 93%

“…This was because of the pedicle anatomy [32]. These results were in accordance with that shown by previous studies [1,19,21,33].…”

Section: Discussionsupporting

confidence: 93%

Section: Discussionsupporting

confidence: 91%

Section: Discussionsupporting

confidence: 85%

Section: Discussionsupporting

confidence: 82%

See 3 more Smart Citations

Postoperative 320 multi-slice computed tomography in assessment of pedicle screw insertion in thoraco-lumbar fixation

Salama

Amin

Soliman

et al. 2019

Egypt J Radiol Nucl Med

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Hybrid composite pedicle screw - finite element modelling with parametric optimization

Becker

Motsch

Hausmann

et al. 2020

Informatics in Medicine Unlocked

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Freehand thoracic pedicle screw technique using a uniform entry point and sagittal trajectory for all levels: preliminary clinical experience

Fennell¹,

Palejwala²,

Skoch³

et al. 2014

SPI

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Object Experience with freehand thoracic pedicle screw placement is well described in the literature. Published techniques rely on various starting points and trajectories for each level or segment of the thoracic spine. Furthermore, few studies provide specific guidance on sagittal and axial trajectories. The goal of this study was to propose a uniform entry point and sagittal trajectory for all thoracic levels during freehand pedicle screw placement and determine the accuracy of this technique. Methods The authors retrospectively reviewed postoperative CT scans of 33 consecutive patients who underwent open, freehand thoracic pedicle-screw fixation using a uniform entry point and sagittal trajectory for all levels. The same entry point for each level was defined as a point 3 mm caudal to the junction of the transverse process and the lateral margin of the superior articulating process, and the sagittal trajectory was always orthogonal to the dorsal curvature of the spine at that level. The medial angulation (axial trajectory) was approximately 30° at T-1 and T-2, and 20° from T-3 to T-12. Breach was defined as greater than 25% of the screw diameter residing outside of the pedicle or vertebral body. Results A total of 219 thoracic pedicle screws were placed with a 96% accuracy rate. There were no medial breaches and 9 minor lateral breaches (4.1%). None of the screws had to be repositioned postoperatively, and there were no neurovascular complications associated with the breaches. Conclusions It is feasible to place freehand thoracic pedicle screws using a uniform entry point and sagittal trajectory for all levels. The entry point does not have to be adjusted for each level as reported in existing studies, although this technique was not tested in severe scoliotic spines. While other techniques are effective and widely used, this particular method provides more specific parameters and may be easier to learn, teach, and adopt.

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Role of postoperative multislice computed tomography in assessment of pedicle screw placement in spinal surgical fixation

Cited by 3 publications

References 31 publications

Postoperative 320 multi-slice computed tomography in assessment of pedicle screw insertion in thoraco-lumbar fixation

Postoperative 320 multi-slice computed tomography in assessment of pedicle screw insertion in thoraco-lumbar fixation

Hybrid composite pedicle screw - finite element modelling with parametric optimization

Freehand thoracic pedicle screw technique using a uniform entry point and sagittal trajectory for all levels: preliminary clinical experience

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