Thoracic pedicle screw fixation techniques are still controversial for thoracic deformities because of possible complications including neurologic deficit. Methods to aid the surgeon in appropriate screw placement have included the use of intraoperative fluoroscopy and/or radiography as well as image-guided techniques. We describe our technique for free hand pedicle screw placement in the thora...

BACKGROUND The training of orthopedic residents in adequate pedicle screw placement is very important. We sought to investigate orthopedic residents' perspectives on the use of computer-assisted surgery (CAS) in a training trial. METHODS Orthopedic residents were randomly assigned to independently place a screw using the free-hand technique and the CAS technique on 1 of 3 cadavers (Cobb angle...

The use of posterior cervical spine fixation has become increasingly popular in recent years. Dissatisfaction with lateral mass fixation, especially at the cervicothoracic junction, has led spine surgeons to use cervical pedicle screw fixation for reconstruction in numerous cervical spine disorders. The biomechanical advantage of a three-column fixation device implanted to secure an unstable ce...

BACKGROUND This study aimed to evaluate the clinical efficacy of use of a 3D printing guide plate in posterior lumbar pedicle screw fixation. MATERIAL AND METHODS We enrolled 43 patients receiving posterior lumbar pedicle screw fixation. The experimental group underwent 3D printing guide plate-assisted posterior lumbar pedicle screw fixation, while the control group underwent traditional x-ray-...

STUDY DESIGN Controlled, cadaveric implantation trial. OBJECTIVE To evaluate the effect of a robotic guidance system on screw placement accuracy, amount of radiation exposure, and length of procedure time during percutaneous pedicle screw implantation. SUMMARY OF BACKGROUND DATA Pedicle screws are associated with low complication rates, and several computer-assisted image guidance systems e...

OBJECTIVE A variety of different pedicle screws entry point techniques are used for the lumbar pedicle screws placement. This study reported Kim's entry point of lumbar pedicle screws with free hand technique and the accuracy of this technique. METHODS We retrospectively reviewed the 584 cases with free hand placed lumbar pedicle screw placement. The diagnosis included 491 cases with degenera...

Study Design A retrospective computed tomography (CT)-based morphometric study of 84 C1pedicles in an Indian population focusing on critical morphometric dimensions vis-a-vis C1 pedicle screw placement. Purpose To determine the feasibility of C1 pedicle screw placement in an Indian population and propose a novel classification system for the same. Overview of Literature At present, C1 pedic...

STUDY DESIGN Evaluation using 3-dimensional screw trajectory software and computed tomographic scans. OBJECTIVE To investigate the anatomic feasibility of laminar screw placement in the upper thoracic spine compared with pedicle screw placement. SUMMARY OF BACKGROUND DATA Although laminar screws have been suggested as an alternative to pedicle screws in the upper thoracic spine, previous an...

The incidence of pedicle screw breech varies based on anatomic location, body habitus, surgeon experience, spinal deformity, and surgical technique. Pedicle breeches have been reported to occur in up to 40% of screws. The purpose of this retrospective study was to compare the rates of revision of pedicle screw placement when using intraoperative C-arm vs O-arm (Medtronic, Memphis, Tennessee) as...

BACKGROUND Pedicle screw instrumentation is widely used for spinal stabilization. However, the accuracy for free-hand screw placement ranges from 69% to 94%. This study assesses the value of the existing classification systems, and investigates their impact on the ability to assess the accuracy of free-hand screw placement. METHODS Data were collected retrospectively from the medical records ...