RT Journal Article
SR Electronic
T1 Freehand Regional Techniques for Subaxial Cervical Pedicle Screw Placement
JF International Journal of Spine Surgery
JO Int J Spine Surg
FD International Society for the Advancement of Spine Surgery
SP 863
OP 867
DO 10.14444/8339
VO 16
IS 5
A1 Li, Kepeng
A1 Miao, Jun
A1 Han, Ye
A1 Lan, Jie
YR 2022
UL https://www.ijssurgery.com/content/16/5/863.abstract
AB Background Although various subaxial cervical pedicle screw implantation techniques have been proposed, clinical operators have been unable to exactly determine the entry points and trajectory . The objective of this article is to propose freehand regional techniques (FRT) for subaxial cervical pedicle screw placements and to investigate the clinical effectiveness of FRT.Methods A total of 80 consecutive patients who underwent open subaxial cervical pedicle screw fixation using FRT from January 2015 to December 2020 were retrospectively reviewed, and preoperative cervical computed tomography (CT) images were used to observe the entry point and screw trajectory. The horizontal and vertical lines at the center of the cervical lateral mass was marked, and the entry point was chosen at the outer upper quadrant of the lateral mass. Both sagittal and axial trajectories were determined by CT images, generally perpendicular to the cervical laminae. Screw implantation accuracy was assessed using postoperative CT.Results After virtually inserting pedicle screws by FRT on preoperative cervical CT images, all of the entry points were located in the outer upper quadrant of the lateral mass and the trajectory perpendicular to the cervical laminae was just parallel to the pedicle’s axis. A total of 694 pedicle screws were placed by FRT clinically, with a 96% accuracy rate.Conclusions Pedicle screw implantation by FRT for subaxial cervical spine can be performed with acceptable safety and accuracy.