RT Journal Article
SR Electronic
T1 A Novel Intraoperative Technique to Determine Cranio-Caudal Angulation of Pedicle Screws in Thoracolumbar Spine: A Prospective Computerized Tomography–Based Analysis of 428 Screws
JF International Journal of Spine Surgery
JO Int J Spine Surg
FD International Society for the Advancement of Spine Surgery
SP 722
OP 730
DO 10.14444/7104
VO 14
IS 5
A1 PATIL, NIRMAL D.
A1 DAHAPUTE, ADITYA
YR 2020
UL https://www.ijssurgery.com/content/14/5/722.abstract
AB Background: We report a novel technique of directing the sagittal profile of thoracic and lumbar pedicle screws using a freehand technique without the use of intraoperative monitoring.Methods: This is a prospective computerized tomography (CT)–based evaluation of pedicle screw insertion in the thoracic and lumbar spine of 64 patients operated upon for varied etiologies. All the patients were operated upon independently by 2 young surgeons with 1 year of spinal-fellowship experience. Intraoperatively, a right-angle retractor was positioned to determine the sagittal inclination of the pedicle screw. Postoperatively, sagittal CT scans were analyzed for the sagittal profile of the screw. The vertebral bodies were divided into 3 equidistant zones (A, B, and C) from the superior to inferior endplates, and the positions of the screw tips were noted.Results: There were 41 men and 23 women (mean age = 45.5 years). A total of 428 screws were inserted. There were 2 cases of superior pedicle wall violation in D1 and D5. The majority (96.97%) of the pedicle screws were inserted into zones A and B.Conclusions: We introduced a simple, accurate, and safe method of directing the sagittal inclination of the pedicle screw in the thoracic and lumbar spine without intraoperative image guidance.