STUDY DESIGN Prospective, randomized, controlled study. OBJECTIVE To report the results of using the PediGuard (SpineGuard, Inc., San Francisco, CA), a local electrical conductivity measurement device, to reduce radiation exposure while drilling the pilot hole for pedicle screw placement. SUMMARY OF BACKGROUND DATA Reports of pedicle screw placement in the lumbar spine have shown medial ped...

In some scenarios, such as complex revisions or tumor cases, intralaminar screw placement in the upper thoracic spine can be used to supplement or replace traditional pedicle screw placement. Despite the theortic feasibility of placing these screws, no thorough anatomic study has evaluated the morphology of the T1 lamina for screw placement.Anatomic data of the T1 lamina, including height, widt...

STUDY DESIGN A retrospective analysis of 1078 spinal surgical procedures with lumbar pedicle screw placement at a single institution. OBJECTIVE Based on previously established normative values, triggered electromyographic stimulation (TrgEMG) was re-examined to evaluate its efficacy in determining screw malposition. SUMMARY OF BACKGROUND DATA Threshold values for confirmation of intraosseou...

AIM Misplacement of pedicle screw is the serious complication of spinal surgeries. Intraoperative imaging techniques and navigation systems are currently in use for the prevention of this complication. The aim of this study was to document the results of our experience with the navigation and intraoperative imaging technique and to share our experience with our colleagues. MATERIAL AND METHOD...

INTRODUCTION Pedicle screw fixation allows purchase of all three spinal columns without encroaching into the spinal canal improving fracture fixation, as well as deformity correction. Fortunately, neurologic injury associated with pedicle screw malposition is rare. CASE PRESENTATION A 19-year-old boy was surgically treated for severe right thoracic scoliosis associated with a Chiari Type 1 ma...

OBJECTIVE Transpedicular screws are commonly and successfully used for posterior fixation in spinal instability, but their insertion remains challenging. Even using navigation techniques, there is a misplacement rate of up to 11%. The aim of this study was to assess the accuracy of a novel pedicle screw system. METHODS Thoracic and lumbar fusions were performed on 67 consecutive patients for ...

BACKGROUND A quantitative screw accuracy system is proposed that allows for high-fidelity discrimination between various methods of pedicle screw insertion. Our purpose was to study the utility of a quantitative screw accuracy scoring system to assess new imaging technologies and their effects on the minimally invasive spine learning curve. METHODS By use of a hypothetical "perfect screw," a ...

STUDY DESIGN Retrospective study evaluating cranial facet joint violation (FJV) by pedicle screws. OBJECTIVE The aim of the study was to determine the incidence and risk factors of FJV following screw placement via cortical bone trajectory (CBT). SUMMARY OF BACKGROUND DATA CBT is a new minimally invasive technique for lumbar pedicle screw insertion that minimizes muscle dissection. Insertin...

Intraoperative monitoring (IOM) is commonly used during lumbar fusion surgery for the prevention of nerve root injury. Justification for its use stems from the belief that IOM can prevent nerve root injury during the placement of pedicle screws. A thorough literature review was conducted to determine if the use of IOM could prevent nerve root injury during the placement of instrumentation in lu...

BACKGROUND This study aimed to evaluate the application of 3D printing in assisting preoperative plan of pedicle screw placement for treating middle-upper thoracic trauma. METHODS A preoperative plan was implemented in seven patients suffering from middle-upper thoracic (T3-T7) trauma between March 2013 and February 2016. In the 3D printing models, entry points of 56 pedicle screws (Magerl me...