Transpedicle Screw Fixation of the Cervical Spine

Ludwig, Steven C.; Kramer, David L.; Vaccaro, Alexander R.; Albert, Todd J.

doi:10.1097/00003086-199902000-00009

Cited by 140 publications

(113 citation statements)

References 17 publications

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“…Biomechanical studies have shown that pedicle screws provide increased rigidity and construct stiffness compared to other posterior fixation techniques [32,33]. It is a technically demanding procedure and studies have shown an alarmingly high rate of screw misplacement varying between 21 and 39.8% with conventional insertion techniques [1][2][3].…”

Section: Discussionmentioning

confidence: 99%

“…The reported pedicle screw misplacement in historical spinal literature can be as high as [20][21][22][23][24][25][26][27][28][29][30][31][32][33][34][35][36][37][38][39].8% [1][2][3], but only a small number leads to complications (neurological, vascular or visceral injuries). But these complications can be potentially life and limb threatening.…”

Section: Introductionmentioning

confidence: 99%

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Functional outcome of computer-assisted spinal pedicle screw placement: a systematic review and meta-analysis of 23 studies including 5,992 pedicle screws

et al. 2010

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A number of studies have shown increased accuracy of pedicle screw placement in spine with the help of computer-assisted navigation. The literature is lacking in regard to functional benefit derived from this technique. The aim of this systematic review was to look at the functional outcomes following computer-assisted pedicle screw placement in spine. A 'Dialog Datastar' search was used using optimized search strategy covering the period from 1950 to July 2009; 23 papers were finally included which met our inclusion criteria. We report on a total of 1,288 patients with 5,992 pedicle screws. The comparison of neurological complications in two groups demonstrated an odds ratio of 0.25 (95% CI 0.06, 1.14) in favour of using navigation for pedicle screw insertion (p = 0.07). Comparative trials demonstrated a significant advantage in terms of accuracy of navigation over conventional pedicle screw insertion with a relative risk of 1.12 (95% CI 1.09, 1.15) (p \ 0.00001). Navigation does not show statistically significant benefit in reducing neurological complications and there was insufficient data in the literature to infer a conclusion in terms of fusion rate, pain relief and health outcome scores.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Functional outcome of computer-assisted spinal pedicle screw placement: a systematic review and meta-analysis of 23 studies including 5,992 pedicle screws

et al. 2010

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“…Over the years, the focus has been on describing cervical pedicle morphology [6,11,14,22,24,27,30,32,35] to give the surgeon as much anatomical information as possible. In 1994, Abumi [1], one of the first surgeons to advocate cervical pedicle screw placement, stated that the angle of insertion should be between 25°and 45°to the sagittal plane, depending on the level at which the surgeon was operating.…”

Section: Introductionmentioning

confidence: 99%

“…In 1994, Abumi [1], one of the first surgeons to advocate cervical pedicle screw placement, stated that the angle of insertion should be between 25°and 45°to the sagittal plane, depending on the level at which the surgeon was operating. Since then, the ideal trajectory has been described as being between 35°and 55° [6,11,22,32] from the sagittal plane.…”

Section: Introductionmentioning

confidence: 99%

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The ipsilateral lamina–pedicle angle: can it be used to guide pedicle screw placement in the sub-axial cervical spine?

et al. 2009

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Pedicle screws in the sub-axial spine are infrequently used because of concerns over their safety and difficulty in placement, despite their superior pullout strength. In the sub-axial cervical vertebrae, we have observed that the lamina appears to project at right angles to the ipsilateral pedicle axis. The aim of this investigation was to confirm the lamina orientation as a reliable landmark for pedicle screw placement. 80 digital cervical spine CT were analysed. The angle formed by the ipsilateral outer lamina cortex to the pedicle axis was recorded. A total of 398 vertebrae were analysed from patients with a mean age of 39.5 years (range 18-78). Average axial lamina-pedicle angle ranged from 96.6°at C3 to 87.2°at C7 in males, and from 95.6°to 87.5°in females. The angle formed by the posterior cortex of the lamina and the ipsilateral pedicle shows a high level of consistency for subaxial cervical vertebrae ranging from 96°at C3 to 87°at C7. Although the angle is not exactly 90°at all levels as hypothesised, the orientation of the lamina, nevertheless, forms a useful reference plane for insertion of pedicle screws in the sub-axial cervical spine.

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Technical Advances in Pediatric Craniovertebral Junction Surgery

Oppenlander

Kalyvas

Sonntag

et al. 2013

Pediatric Craniovertebral Junction Diseases

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Surgery for conditions in the craniovertebral junction in the pediatric population poses unique challenges. The posterior approach has emerged as the gold standard for arthrodesis in this region. Anterior fixation or decompression also may be indicated. Intraoperative image guidance and neurophysiological monitoring improve the safety and efficacy of these procedures. The specific technical advances in surgery of the craniovertebral junction that have improved patient outcomes are reviewed.

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Transpedicle Screw Fixation of the Cervical Spine

Cited by 140 publications

References 17 publications

Functional outcome of computer-assisted spinal pedicle screw placement: a systematic review and meta-analysis of 23 studies including 5,992 pedicle screws

Functional outcome of computer-assisted spinal pedicle screw placement: a systematic review and meta-analysis of 23 studies including 5,992 pedicle screws

The ipsilateral lamina–pedicle angle: can it be used to guide pedicle screw placement in the sub-axial cervical spine?

Technical Advances in Pediatric Craniovertebral Junction Surgery

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