ABSTRACT
Purpose: This study evaluated a practical, safe and accurate method of thoracic pedicle screw insertion for the surgical treatment of scoliosis using the posteroanterior C-arm fluoroscopy rotation method. Materials and Methods: A total of 611 thoracic pedicle screws were inserted in 45 patients using the posteroanterior (PA) C-arm rotation method. CT scans were taken postoperatively in the transverse and sagittal sections to evaluate the pedicle screw placement. Results: A mean preoperative curve of 57.7o was corrected to 17.1o (range, 3o-45o) in the coronal plane. The postoperative CT scans revealed that 10 screws (1.6%) had penetrated the medial cortex by a mean distance of 3.0 mm and 56 screws (9.2%) penetrated the lateral cortex by a mean distance of 3.5 mm. No screw penetrated the inferior or superior cortex in the sagittal plane. However, 21 screws (3.4%) penetrated the anterior cortex. No neurological or vascular complications were encountered, and none of the screws required replacement. Conclusion: Thoracic pedicle screw insertion in scoliosis patients using the posteroanterior C-arm rotation method is a practical, simple and safe technique that allows the en face visualization of both pedicles by rotating the C-arm to compensate for the rotational deformity.