Use of Cervicothoracic Junction Pedicle Screws for Reconstruction of Complex Cervical Spine Pathology

Abstract

Pedicle screws in C7 placed with laminoforaminotomy and palpation technique appears to be safe and efficacious. Excellent fixation can be achieved.

Cervical pedicle screw placement: feasibility and accuracy of two new insertion techniques based on morphometric data

“…The angulation for the CPS was determined by placing a dental probe through the laminar window onto the superior, medial and inferior borders of the pedicle. Different open techniques have already proven to reduce the incidence and severity of pedicle violations [6,8,16,19,24,33,34]. So far, surgery with computer-assisted image guidance systems (CAS) seems to have the lowest pedicle violation rate [21,27,33,37,41].…”

Computed Tomography Morphometric Analysis of the Vertebrae C7 and T1

“…15 The principal challenge in using transpedicle screws in the cervical region is in the technical difficulty of insertion, due to the size of the pedicles and the potentially serious complications, such as lesion of the vertebral arteries, of the spinal cord, and of the nerve roots. 5 The intraoperative use of radioscopy can assist with the placement of these screw. 16 However, positioning the radioscope to obtain suitable images may be difficult in some cases.…”

“…1 There are various techniques that make fixation of the cervico-thoracic transition possible using the posterior approach. [2][3][4] The most common techniques are those that use screws that can be fixed to the lateral masses or to the pedicles; 3,5 however there are limitations, due to the complication rates reported. 6,7 There is information in the literature about the anatomical characteristics of the spine in studies with cadavers.…”

Posterior Fusion in Cervical Spine Surgery

“…Результаты многих исследований свидетельствуют о том, что примене-ние конструкций такого типа может являться методом выбора при наличии костных дефектов заднего опорного комплекса ПДС шейного отдела позво-ночника, особенно при необходимос-ти выполнения мультисегментарного ЗЦС [11,20,26,29,30]. Однако на науч-ных форумах и страницах специаль-ных изданий продолжается дискуссия как о целесообразности применения той или иной фиксирующей систе-мы на основе стержней, так и о пре-имуществах и недостатках различных траекторий проведения винтов в сус-тавные массы шейных позвонков [21,29,43].…”