OBJECTIVE To evaluate the feasibility, safety and accuracy of pedicle screw placement in the upper thoracic spine using the free-hand technique with the aid of fluoroscopy; to analyze the methods used to verify correct screw positioning intra and postoperatively. METHOD All patients with instability of the cervicothoracic or upper thoracic spine and at least one screw placed in the segment T1...

Spine stabilization after C3-C7 laminectomy can be accomplished with many instrumentation options. A hybrid construct using lateral mass screws from C3 to C5 and pedicle screws at C7 can potentially maximize strength and solve the spatial constraints introduced by the placement of C6 lateral mass screws and C7 pedicle screws. Seven cadaveric cervical spines from C2 to T2 were potted in a custom...

BACKGROUND Computerized navigation improves the accuracy of minimally invasive pedicle screw placement during spine surgery. Such navigation, however, exposes both the patient and the staff to radiation during surgery. To avoid intraoperative exposure to radiation, tracked ultrasound snapshots-ultrasound image frames coupled with corresponding spatial positions-could be used to map preoperative...

This article describes factors affecting the accuracy of transpedicle screw placements performed with the Renaissance robot-guided system and reviews the relevant literature. Between January 2013 and January 2015, Renaissance robot-guided spinal surgery was performed in 125 patients at Kaohsiung Medical University Hospital in Kaohsiung, Taiwan. The surgeries included 662 transpedicle screw impl...

BACKGROUND Pedicle screws are used increasingly in spine surgery. Concerns of complications associated with screw breach necessitates accurate pedicle screw placement. Postoperative CT imaging helps to detect screw malposition and assess its severity. However, accuracy is dependent on the reading of the CT scans. Inter- and intra-observer variability could affect the reliability of CT scans to ...

OBJECTIVE To evaluate the anatomical feasibility of 3.5 mm screw into the cervical spine in the pediatric population and to establish useful guidelines for their placement. METHODS A total of 37 cervical spine computerized tomography scans (24 boys and 13 girls) were included in this study. All patients were younger than 10 years of age at the time of evaluation for the period of 2007-2011. ...

STUDY DESIGN Retrospective. OBJECTIVE To evaluate the clinical safety and accuracy of the Tai Chi ((Equation is included in full-text article.)) technique for placing pedicle screws, without intraoperative radiographic imaging, in severe scoliotic spines. SUMMARY OF BACKGROUND DATA The current techniques for pedicle screw placement have a number of drawbacks in cases of severe scoliosis, in...

AIM To demonstrate the incidence of screw misplacement and revision rates in a group of 72 patients that underwent pedicle screw fixation for spinal pathologies using the conventional, fluoroscopy-guided open technique. MATERIAL AND METHODS Data from 72 consecutive patients with spinal instability that received 472 screws between April 2011 and May 2013 were reviewed and pedicle wall breach w...

The C2 pedicle screw is more biomechanically stable and provides patients with increased postoperative range of motion in comparison to other methods of C2 fixation. However, as a result of the proximity of the C2 pedicle to the transverse foramen, there is a considerable risk of intraoperative morbidity due to vertebral artery injury laterally or vertebral canal breach medially. Other than the...

The aim of this study was to evaluate the anatomical variations and injuries in patients with unstable Hangman fractures that affected the posterior pedicle screw placement of C2 to C3 and retrospectively review our experience with management of these fractures. Clinical data were reviewed in 72 patients with unstable Hangman fractures, especially using 3-dimensional computed tomography (3D-CT)...