STUDY DESIGN A computer-assisted planning and visualization system (the Orthopaedic Surgery Planning System) was tested for pedicle screw insertion in vivo. OBJECTIVES To evaluate the system's applicability for regular intraoperative use and its accuracy for pedicle screw placement in vivo. SUMMARY OF BACKGROUND DATA Pedicle screw placement poses considerable anatomic and biomechanical risk...

We prospectively studied the use of intercostal EMG monitoring as an indicator of the accuracy of the placement of pedicle screws in the thoracic spine. We investigated 95 thoracic pedicles in 17 patients. Before insertion of the screw, the surgeon recorded his assessment of the integrity of the pedicle track. We then stimulated the track using a K-wire pedicle probe connected to a constant cur...

STUDY DESIGN A retrospective review of charts, x-rays (XRs) and computed tomography (CT) scans was performed. OBJECTIVE To evaluate the accuracy of pedicle screw placement using a novel classification system to determine potentially significant screw misplacement. SUMMARY OF BACKGROUND DATA The accuracy rate of pedicle screw (PS) placement varies from 85% to 95% in the literature. This demo...

STUDY DESIGN This investigation was conducted in two parts. In the first part, a morphometric analysis of critical cervical pedicle dimensions were measured to create guidelines for cervical pedicle screw fixation based on posterior cervical topography. In the second part of the study, a human cadaver model was used to assess the accuracy and safety of transpedicular screw placement in the suba...

BACKGROUND The learning and development of technical skills are paramount for neurosurgical trainees. External influences and a need for maximizing efficiency and proficiency have encouraged advancements in simulator-based learning models. OBJECTIVE To confirm the importance of establishing an educational curriculum for teaching minimally invasive techniques of pedicle screw placement using a...

OBJECT The authors introduce a unique computer-assisted cervical pedicle screw (CPS) insertion technique used in conjunction with specially modified original pedicle screw insertion instruments. The accuracy of screw placement as well as surgery-related outcome and complication rates were compared between two groups of patients: those in whom a computer-assisted and those in whom a conventional...

Study Design A retrospective analysis of a prospective database. Objective Meta-analyses suggest that computer-assisted systems can increase the accuracy of pedicle screw placement for dorsal spinal fusion procedures. The results of further meta-analyses report that in the thoracic spine, both the methods have comparable placement accuracy. These studies are limited due to an abundance of screw...

Correct screw placement is especially difficult in the upper thoracic vertebrae. At the cervicothoracic junction (C7-T2), problems can arise because of the narrowness of the pedicle and the difficulty of using a lateral image intensifier there. Other upper thoracic vertebrae (T3-6) pose a problem for screw insertion also because of the narrower pedicle. We inserted 154 pedicle screws into 78 ve...

BACKGROUND The pedicle screw placement in scoliosis correction at the apex underlies potential risk for neurological injury. This research is to investigate the relative position of spinal cord at the apex in idiopathic thoracic scoliosis and to explore the risk of spinal cord injury from pedicle screw at the apex. METHODS Thirty-three adolescents with thoracic scoliosis were recruited in thi...

BACKGROUND The foremost concern of a surgeon during pedicle screw fixation is safety. Assistive modalities, especially intraoperative electromyographic monitoring (EMG) can function as an essential tool to recognize screw malposition that compromise neural integrity, so that the screws can be repositioned immediately rather than later. We intend to study the efficacy of intraoperative EMG monit...