Thoracic Pedicle Screw Insertion in Scoliosis Using Posteroanterior C-arm rotation Method / 대한척추외과학회지
Journal of Korean Society of Spine Surgery
;
: 123-131, 2005.
Article
in Korean
| WPRIM
| ID: wpr-113271
ABSTRACT
STUDY DESIGN:
A prospective study of the accuracy of thoracic pedicle screws inserted in scoliotic patients.OBJECTIVES:
To evaluate and present a practical, safe and accurate method for thoracic pedicle screw insertion in the surgical treatment of scoliosis using the posteroanterior c-arm fluoroscopy rotating method. SUMMARY OF LITERATURE REVIEW Previous studies have emphasized the clinical importance, yet difficulty, of accurate thoracic pedicle screw insertion in scoliotic patients. Three-dimensional alterations in the pedicle orientation of scoliotic patients makes the accurate insertion challenging. No reports exist on the accuracy and benefits of posteroanterior c-arm fluoroscopy, which is rotated to allow visualization from en face, in real patients. MATERIALS ANDMETHODS:
A total of 350 thoracic pedicle screws were inserted in 29 patients, including 24 with idiopathic scoliosis, using the posteroanterior (PA) c-arm rotation method. The smallest patient weighed 14 kg, and the next smallest 17 kg. The average preoperative curve was 60.9 degrees(range, 45 degrees~101 degrees). CT scans were taken, postoperatively, in the transverse and sagittal sections to evaluate the pedicle screw placement.RESULTS:
The mean preoperative curve of 60.9 degrees was corrected to 15.4 degrees(range, 3 degrees~45 degrees) in the coronal plane, a correction of 74.7%. A mean of 12.1 thoracic screws were inserted per patient. On analysis of the postoperative CT scans, 39(11.1%) of the 350 screws penetrated the medial or lateral pedicle cortices, 8(2.3%) into the medial cortex and 31(8.9%) into the lateral cortex, by mean distances of 3.3 and 3.6 mm, respectively. No screws penetrated the inferior or superior cortices in the sagittal plane, but 16(4.6%) penetrated the anterior cortex. No neurological or vascular complications were encountered, and none of the screws required subsequent replacement.CONCLUSIONS:
Thoracic pedicle screw insertion in scoliotic patients, using a posteroanterior c-arm rotation method, allows the en face visualization of both pedicles by rotating the c-arm to compensate for rotational deformity, which makes it a practical, simple and safe method.
Full text:
Available
Index:
WPRIM (Western Pacific)
Main subject:
Scoliosis
/
Congenital Abnormalities
/
Fluoroscopy
/
Tomography, X-Ray Computed
/
Prospective Studies
Type of study:
Observational study
Limits:
Humans
Language:
Korean
Journal:
Journal of Korean Society of Spine Surgery
Year:
2005
Type:
Article
Similar
MEDLINE
...
LILACS
LIS