• Spine · Sep 2015

    Accuracy and Safety of Fluoroscopic Guided Percutaneous Pedicle Screws in Thoracic and Lumbosacral Spine: A Review of 2000 screws.

    • Nils Hansen-Algenstaedt, Chee Kidd Chiu, Chan Chris Yin Wei CY, Chee Kean Lee, Christian Schaefer, and Mun Keong Kwan.
    • *Department of Orthopaedics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany †Orthocentrum Hamburg, Department of Spine Surgery, Parkklinik Manhagen, Hansastrasse, Hamburg, Germany ‡Department of Orthopaedic Surgery (NOCERAL), University of Malaya, Kuala Lumpur, Malaysia; and §Department of Spine Surgery, Rheumaklinik Bad Bramstedt, Oskar Alexander Strasse, Bad Bramstedt, Germany.
    • Spine. 2015 Sep 1; 40 (17): E954-63.

    Study DesignRetrospective study.ObjectiveTo investigate the accuracy and safety of percutaneous pedicle screws placed using fluoroscopic guidance in the thoracic and lumbosacral spine.Summary Of Background DataSeveral studies had examined the accuracy and safety of percutaneous pedicle screws but provided large variations in their results with small number of patients or few number of pedicle screws evaluated.MethodsComputerized tomography of patients who had surgery with fluoroscopic guided percutaneous pedicle screws were chosen from 2 centers: (1) European patients from University Medical Center Hamburg-Eppendorf, Germany and (2) Asian patients from University Malaya Medical Centre, Malaysia. Screw perforations were classified into Grade 0, Grade 1 (<2 mm), Grade 2 (2-4 mm), and Grade 3 (>4 mm).ResultsIn total, 2000 percutaneous pedicle screws from 273 patients were analyzed: 1290 screws from 183 European patients and 710 screws from 90 Asian patients. The mean age was 59.1 ± 15.6. There were 140 male patients and 133 female patients. The total perforation rate was 9.4% with 151 (7.5%) Grade 1, 31 (1.6%) Grade 2, and 5 (0.3%) Grade 3 perforations. The total perforation rates among Europeans were 9.4% and among Asians were 9.3%. There was no difference between the 2 groups (P > 0.05). There were 3 distinct peaks in perforation rates (trimodal distribution) at T1, midthoracic region (T4-T7), and lumbosacral junction (L5 and S1). The highest perforation rates were at T1 (33.3%), S1 (19.4%), and T4 (18.6%).ConclusionImplantation of percutaneous pedicle screws insertion using fluoroscopic guidance is safe and has the accuracy comparable to open techniques of pedicle screws insertion.Level Of Evidence4.

      Pubmed     Full text   Copy Citation     Plaintext  

      Add institutional full text...

    Notes

     
    Knowledge, pearl, summary or comment to share?
    300 characters remaining
    help        
    You can also include formatting, links, images and footnotes in your notes
    • Simple formatting can be added to notes, such as *italics*, _underline_ or **bold**.
    • Superscript can be denoted by <sup>text</sup> and subscript <sub>text</sub>.
    • Numbered or bulleted lists can be created using either numbered lines 1. 2. 3., hyphens - or asterisks *.
    • Links can be included with: [my link to pubmed](http://pubmed.com)
    • Images can be included with: ![alt text](https://bestmedicaljournal.com/study_graph.jpg "Image Title Text")
    • For footnotes use [^1](This is a footnote.) inline.
    • Or use an inline reference [^1] to refer to a longer footnote elseweher in the document [^1]: This is a long footnote..

    hide…