Inserting pedicle screws in the upper thoracic spine without the use of fluoroscopy or image guidance. Is it safe?

Details

Serval ID
serval:BIB_ACB09D1E2166
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Inserting pedicle screws in the upper thoracic spine without the use of fluoroscopy or image guidance. Is it safe?
Journal
European Spine Journal
Author(s)
Schizas C., Theumann N., Kosmopoulos V.
ISSN
0940-6719
Publication state
Published
Issued date
05/2007
Peer-reviewed
Oui
Volume
16
Number
5
Pages
625-629
Language
english
Notes
Clinical Trial Schizas, Constantin Theumann, Nicolas Kosmopoulos, Victor Germany European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society Eur Spine J. 2007 May;16(5):625-9. Epub 2006 Nov 15. --- Old month value: May
Abstract
Several studies have looked at accuracy of thoracic pedicle screw placement using fluoroscopy, image guidance, and anatomical landmarks. To our knowledge the upper thoracic spine (T1-T6) has not been specifically studied in the context of screw insertion and placement accuracy without the use of either image guidance or fluoroscopy. Our objective was to study the accuracy of upper thoracic screw placement without the use of fluoroscopy or image guidance, and report on implant related complications. A single surgeon inserted 60 screws in 13 consecutive non-scoliotic spine patients. These were the first 60 screws placed in the high thoracic spine in our institution. The most common diagnosis in our patient population was trauma. All screws were inserted using a modified Roy-Camille technique. Post-operative axial computed tomography (CT) images were obtained for each patient and analyzed by an independent senior radiologist for placement accuracy. Implant related complications were prospectively noted. No pedicle screw misplacement was found in 61.5% of the patients. In the remaining 38.5% of patients some misplacements were noted. Fifty-three screws out of the total 60 implanted were placed correctly within all the pedicle margins. The overall pedicle screw placement accuracy was 88.3% using our modified Roy-Camille technique. Five medial and two lateral violations were noted in the seven misplaced screws. One of the seven misplaced screws was considered to be questionable in terms of pedicle perforation. No implant related complications were noted. We found that inserting pedicle screws in the upper thoracic spine based solely on anatomical landmarks was safe with an accuracy comparable to that of published studies using image-guided navigation at the thoracic level.
Keywords
Adolescent, Adult, Aged, Aged, 80 and over, Bone Screws, Female, Fluoroscopy, Humans, Male, Middle Aged, Postoperative Complications, Safety, Spinal Diseases, Spinal Fusion, Thoracic Vertebrae, Tomography, X-Ray Computed, Treatment Outcome
Pubmed
Web of science
Create date
11/04/2008 12:00
Last modification date
20/08/2019 15:16
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