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Perforation rates of cervical pedicle screw insertion by disease and vertebral level.

Uehara M, Takahashi J, Hirabayashi H, Hashidate H, Ogihara N, Mukaiyama K, Ikegami S, Kato H - Open Orthop J (2010)

Bottom Line: Major perforation was defined as perforation 50% of screw diameter or more.Cervical pedicle screw perforation rate by disease was higher in CSM compared to RA and DSA.The perforation rate by vertebral level was higher for C4 and C3, in this order.

View Article: PubMed Central - PubMed

Affiliation: Department of Orthopaedic Surgery, Shinshu University, School of Medicine, 3-1-1 Asahi, Matsumoto-City, Nagano, 390-8621, Japan.

ABSTRACT

Background: Different perforation rates for cervical pedicle screws by disease are expected in relation to bone quality and pedicle morphology; however, no report comparing pedicle screw perforation rate by disease had previously been published. This study investigated the perforation rates of pedicle screws inserted to cervical pedicle by disease and vertebral level using a CT-based navigation system.

Materials/methods: Fifty-three patients who underwent cervical pedicle screw insertion using CT based navigation system were studied. Diseases included rheumatoid arthritis (RA) (24 cases), destructive spondyloarthropathy (DSA) (10), cervical spondylotic myelopathy (CSM) (9), spine tumor (6), and cervical spondylotic myelopathy associated with athetoid cerebral palsy (CP) (4). Screw perforation rates for cervical pedicle screws were studied. Major perforation was defined as perforation 50% of screw diameter or more.

Results: Major perforation rate by disease from C3 to C7 was as follows: spine tumor (0/24, 0%), RA (2/59, 3.4%), DSA (3/65, 4.6%), CP (2/20, 10.0%), and CSM (6/40, 15.0%). There were no clinically important complications such as vertebra arterial injury, spinal cord injury, or nerve root injury caused by any screw perforation. Major perforation rate by vertebral level was: C2(2/30, 6.7%), C3(4/49, 8.2%), C4(6/43, 14.0%), C5(1/32, 3.1%), C6(1/41, 2.4%), and C7(1/45, 2.2%), showing highest rate for C4, followed by C3.

Conclusions: Cervical pedicle screw perforation rate by disease was higher in CSM compared to RA and DSA. The perforation rate by vertebral level was higher for C4 and C3, in this order.

No MeSH data available.


Related in: MedlinePlus

68 year-old female with rheumatoid cervical spine. Pedicle screws were inserted to C6 and C7, and all screws were of grade 1 (no perforation).
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Figure 1: 68 year-old female with rheumatoid cervical spine. Pedicle screws were inserted to C6 and C7, and all screws were of grade 1 (no perforation).

Mentions: Pedicle screws were inserted to C6 and C7. Although the pedicles were narrow, pedicle screws were accurately inserted and all screw insertions were of grade 1 (Fig. 1).


Perforation rates of cervical pedicle screw insertion by disease and vertebral level.

Uehara M, Takahashi J, Hirabayashi H, Hashidate H, Ogihara N, Mukaiyama K, Ikegami S, Kato H - Open Orthop J (2010)

68 year-old female with rheumatoid cervical spine. Pedicle screws were inserted to C6 and C7, and all screws were of grade 1 (no perforation).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2864428&req=5

Figure 1: 68 year-old female with rheumatoid cervical spine. Pedicle screws were inserted to C6 and C7, and all screws were of grade 1 (no perforation).
Mentions: Pedicle screws were inserted to C6 and C7. Although the pedicles were narrow, pedicle screws were accurately inserted and all screw insertions were of grade 1 (Fig. 1).

Bottom Line: Major perforation was defined as perforation 50% of screw diameter or more.Cervical pedicle screw perforation rate by disease was higher in CSM compared to RA and DSA.The perforation rate by vertebral level was higher for C4 and C3, in this order.

View Article: PubMed Central - PubMed

Affiliation: Department of Orthopaedic Surgery, Shinshu University, School of Medicine, 3-1-1 Asahi, Matsumoto-City, Nagano, 390-8621, Japan.

ABSTRACT

Background: Different perforation rates for cervical pedicle screws by disease are expected in relation to bone quality and pedicle morphology; however, no report comparing pedicle screw perforation rate by disease had previously been published. This study investigated the perforation rates of pedicle screws inserted to cervical pedicle by disease and vertebral level using a CT-based navigation system.

Materials/methods: Fifty-three patients who underwent cervical pedicle screw insertion using CT based navigation system were studied. Diseases included rheumatoid arthritis (RA) (24 cases), destructive spondyloarthropathy (DSA) (10), cervical spondylotic myelopathy (CSM) (9), spine tumor (6), and cervical spondylotic myelopathy associated with athetoid cerebral palsy (CP) (4). Screw perforation rates for cervical pedicle screws were studied. Major perforation was defined as perforation 50% of screw diameter or more.

Results: Major perforation rate by disease from C3 to C7 was as follows: spine tumor (0/24, 0%), RA (2/59, 3.4%), DSA (3/65, 4.6%), CP (2/20, 10.0%), and CSM (6/40, 15.0%). There were no clinically important complications such as vertebra arterial injury, spinal cord injury, or nerve root injury caused by any screw perforation. Major perforation rate by vertebral level was: C2(2/30, 6.7%), C3(4/49, 8.2%), C4(6/43, 14.0%), C5(1/32, 3.1%), C6(1/41, 2.4%), and C7(1/45, 2.2%), showing highest rate for C4, followed by C3.

Conclusions: Cervical pedicle screw perforation rate by disease was higher in CSM compared to RA and DSA. The perforation rate by vertebral level was higher for C4 and C3, in this order.

No MeSH data available.


Related in: MedlinePlus