Feasibility Study of Free-Hand Technique for Pedicle Screw Insertion at C7 without Fluoroscopy-Guidance
Study DesignRetrospective interventional study.PurposeTo introduce a free-hand pedicle screw (PS) insertion technique without fluoroscopic guidance in the C7 vertebra and evaluate the procedure's feasibility and radiologic outcomes.Overview of LiteratureAlthough PS insertion at C7 has been reco...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
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Korean Spine Society
2016-02-01
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| Series: | Asian Spine Journal |
| Subjects: | |
| Online Access: | http://www.asianspinejournal.org/upload/pdf/asj-10-38.pdf |
| _version_ | 1819145990759776256 |
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| author | Gun Woo Lee Ho-Joong Kim Jin S. Yeom Jae-Hyung Uh Jong-Ho Park Ji-Hoon Lee Dong-Wook Kim Bo-Gun Suh |
| author_facet | Gun Woo Lee Ho-Joong Kim Jin S. Yeom Jae-Hyung Uh Jong-Ho Park Ji-Hoon Lee Dong-Wook Kim Bo-Gun Suh |
| author_sort | Gun Woo Lee |
| collection | DOAJ |
| description | Study DesignRetrospective interventional study.PurposeTo introduce a free-hand pedicle screw (PS) insertion technique without fluoroscopic guidance in the C7 vertebra and evaluate the procedure's feasibility and radiologic outcomes.Overview of LiteratureAlthough PS insertion at C7 has been recognized as a critical procedure in posterior cervical fusion surgery, conventional techniques for C7 PS have several limitations.MethodsThirty two patients (64 screws) who underwent PS insertion in C7 with the novel technique were included in this study. Postoperative clinical and radiological outcomes were evaluated. Special attention was paid to the presence of any problems in the screw position including cortical breaches of the PS and encroachment of the PS into the spinal canal or the vertebral foramen. This novel technique for PS insertion in C7 without fluoroscopy guidance had three key elements. First, the ideal PS entry point was chosen near the C6–7 facet joint using preoperative images. Second, the convergent angle distance was measured at axial computed tomography (CT) imaging, which defined the distance between the tip of C7 spinous process and the extended line passing through the pedicle axis from the ideal entry point. Third, the cranial-caudal angle distance was measured in sagittal CT images, which defined the distance between the tip of the C7 spinous process and the extended line passing through the pedicle axis.ResultsCortical breach on postoperative CT images was observed in three screws. All violated only the lateral wall of the affected pedicle. The breached screws occurred in the initial five cases. Postoperative neurologic deterioration was not observed in any patient, regardless of cortical breaching.ConclusionsThe novel technique successfully allows for C7 PS to be placed and is associated with a low rate of cortical breach. |
| first_indexed | 2024-12-22T13:06:49Z |
| format | Article |
| id | doaj.art-617beb513d5341708bf7704ab742a837 |
| institution | Directory Open Access Journal |
| issn | 1976-1902 1976-7846 |
| language | English |
| last_indexed | 2024-12-22T13:06:49Z |
| publishDate | 2016-02-01 |
| publisher | Korean Spine Society |
| record_format | Article |
| series | Asian Spine Journal |
| spelling | doaj.art-617beb513d5341708bf7704ab742a8372022-12-21T18:24:51ZengKorean Spine SocietyAsian Spine Journal1976-19021976-78462016-02-01101384510.4184/asj.2016.10.1.3891Feasibility Study of Free-Hand Technique for Pedicle Screw Insertion at C7 without Fluoroscopy-GuidanceGun Woo Lee0Ho-Joong Kim1Jin S. Yeom2Jae-Hyung Uh3Jong-Ho Park4Ji-Hoon Lee5Dong-Wook Kim6Bo-Gun Suh7Department of Orthopaedic Surgery, Armed Forces Yangju Hospital, Yangju, Korea.Spine Center and Department of Orthopaedic Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Sungnam, Korea.Spine Center and Department of Orthopaedic Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Sungnam, Korea.Spine Center and Department of Orthopaedic Surgery, Pohang Semyeng Christianty Hospital, Pohang, Korea.Spine Center and Department of Orthopaedic Surgery, Pohang Semyeng Christianty Hospital, Pohang, Korea.Spine Center and Department of Rehabilitation, Pohang Semyeng Christianty Hospital, Pohang, Korea.Spine Center and Department of Anesthesiology, Pohang Semyeng Christianty Hospital, Pohang, Korea.Spine Center and Department of Orthopaedic Surgery, Pohang Semyeng Christianty Hospital, Pohang, Korea.Study DesignRetrospective interventional study.PurposeTo introduce a free-hand pedicle screw (PS) insertion technique without fluoroscopic guidance in the C7 vertebra and evaluate the procedure's feasibility and radiologic outcomes.Overview of LiteratureAlthough PS insertion at C7 has been recognized as a critical procedure in posterior cervical fusion surgery, conventional techniques for C7 PS have several limitations.MethodsThirty two patients (64 screws) who underwent PS insertion in C7 with the novel technique were included in this study. Postoperative clinical and radiological outcomes were evaluated. Special attention was paid to the presence of any problems in the screw position including cortical breaches of the PS and encroachment of the PS into the spinal canal or the vertebral foramen. This novel technique for PS insertion in C7 without fluoroscopy guidance had three key elements. First, the ideal PS entry point was chosen near the C6–7 facet joint using preoperative images. Second, the convergent angle distance was measured at axial computed tomography (CT) imaging, which defined the distance between the tip of C7 spinous process and the extended line passing through the pedicle axis from the ideal entry point. Third, the cranial-caudal angle distance was measured in sagittal CT images, which defined the distance between the tip of the C7 spinous process and the extended line passing through the pedicle axis.ResultsCortical breach on postoperative CT images was observed in three screws. All violated only the lateral wall of the affected pedicle. The breached screws occurred in the initial five cases. Postoperative neurologic deterioration was not observed in any patient, regardless of cortical breaching.ConclusionsThe novel technique successfully allows for C7 PS to be placed and is associated with a low rate of cortical breach.http://www.asianspinejournal.org/upload/pdf/asj-10-38.pdfPedicle screwCervical vertebraFluoroscopy |
| spellingShingle | Gun Woo Lee Ho-Joong Kim Jin S. Yeom Jae-Hyung Uh Jong-Ho Park Ji-Hoon Lee Dong-Wook Kim Bo-Gun Suh Feasibility Study of Free-Hand Technique for Pedicle Screw Insertion at C7 without Fluoroscopy-Guidance Asian Spine Journal Pedicle screw Cervical vertebra Fluoroscopy |
| title | Feasibility Study of Free-Hand Technique for Pedicle Screw Insertion at C7 without Fluoroscopy-Guidance |
| title_full | Feasibility Study of Free-Hand Technique for Pedicle Screw Insertion at C7 without Fluoroscopy-Guidance |
| title_fullStr | Feasibility Study of Free-Hand Technique for Pedicle Screw Insertion at C7 without Fluoroscopy-Guidance |
| title_full_unstemmed | Feasibility Study of Free-Hand Technique for Pedicle Screw Insertion at C7 without Fluoroscopy-Guidance |
| title_short | Feasibility Study of Free-Hand Technique for Pedicle Screw Insertion at C7 without Fluoroscopy-Guidance |
| title_sort | feasibility study of free hand technique for pedicle screw insertion at c7 without fluoroscopy guidance |
| topic | Pedicle screw Cervical vertebra Fluoroscopy |
| url | http://www.asianspinejournal.org/upload/pdf/asj-10-38.pdf |
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