Pedicle screw constructs have become the mainstay for surgical correction in patients with spinal deformities. To reduce or avoid the risk of pedicle screw-based complications and to decrease the costs associated with pedicle screw instrumentation, some authors have introduced interval, skipped, and key-vertebral pedicle screw strategies for correction. However, there have been no comparisons o...

STUDY DESIGN Prospective clinical study with postoperative radiologic control of pedicle screw placement in the cervical spine. OBJECTIVES To evaluate whether cervical pedicle screws can be placed safely in a conventional technique when using cannulated screws and separate stab incisions. Also, to evaluate if accuracy and safety of pedicle screw placement can be improved using a computer-assi...

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...

Pedicle screw loosening has been implicated in recurrent back pain after lumbar spinal fusion, but the degree of loosening has not been systematically quantified in patients. Instrumentation removal is an option for patients with successful arthrodesis, but remains controversial. Here, we quantified pedicle screw loosening by measuring screw insertion and/or removal torque at high statistical p...

pedicle screws provide rigid fixation for instabilities in the lumbar and lumbosacral spine. anatomical consideration and potential risk of neurologic complications are the reasons to hesitate using pedicle screws in the thoracic spine. twenty moulages similar to human vertebrae were instrumented with cotrel-dubousset (cd) system pedicle screw by intratransverse process, extrapedicular and intr...

The procedure for removing a broken pedicle screw should ideally be technically easy and minimally invasive, as any damage to the pedicle, during removal of the broken screw, may weaken the pedicle, thus compromising on the success of re-instrumentation. We describe the case of a 32-year old man who had undergone surgery for traumatic third lumbar vertebral body fracture three years prior to cu...

Computer-navigated pedicle screw insertion is applied to the thoracic and lumbar spine to attain high insertion accuracy and a low rate of screw-related complications. However, some in vivo and in vitro studies have shown that no advantages are gained with the use of navigation techniques compared to conventional techniques. Additionally, inconsistent conclusions have been drawn in various stud...

STUDY DESIGN Case-control study. PURPOSE To evaluate clinical and radiological results of transforaminal lumbar interbody fusion (TLIF) performed with cortical bone trajectory (CBT) pedicle screw insertion with those of TLIF using 'conventional' or percutaneous pedicle screw insertion. OVERVIEW OF LITERATURE CBT is a new trajectory for pedicle screw insertion in the lumbar spine; clinical a...

Treatment of unstable thoracolumbar burst fractures remains controversial. Long-segment pedicle screw constructs may be stiffer and impart greater forces on adjacent segments compared with short-segment constructs, which may affect clinical performance and long-term out come. The purpose of this study was to biomechanically evaluate long-segment posterior pedicle screw fixation (LSPF) vs short-...

OBJECTIVE Transpedicular screw fixation has some disadvantages such as postoperative back pain through wide muscle dissection, long operative time, and cephalad adjacent segmental degeneration (ASD). The purposes of this study are investigation and comparison of radiological and clinical results between interspinous fusion device (IFD) and pedicle screw. METHODS From Jan. 2008 to Aug. 2009, 4...