The spine journal : official journal of the North American Spine Society
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Minimally invasive approaches to the lumbar spine allow for pedicle screw placement through a muscle-splitting paraspinal approach. These techniques are highly dependent on fluoroscopy and do not allow for direct visualization of anatomic landmarks. The effect of this on the accuracy of pedicle screw placement is not well described. The purpose of this study was to evaluate the rate of violation of the superior segment facet joint and rates of cortical violation after minimally invasive pedicle screw placement. ⋯ This study revealed a low rate of superior segment facet violation and cortical violation after minimally invasive pedicle screw placement. This rate of superior-level facet involvement is significantly lower than previously reported after open procedures. The rate of cortical violation is similar to previous reports in the literature with a low revision rate.
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Comparative Study
Biomechanical analysis of occipitocervical stability afforded by three fixation techniques.
Occipital condyle screws appear to be a novel technique that demands biomechanical consideration. It has the potential to achieve fixation anterior to the axis of rotation while offering a point of fixation in line with the C1/C2 screws. ⋯ With instrumentation across the mobile OC junction, our results indicate that similar stability can be achieved with occipital condyle screws/eyelet screws compared with the standard occipitocervical plate/rod system.