Bredow, J., Oppermann, J., Kraus, B., Schiller, P., Schiffer, G., Sobottke, R., Eysel, P. and Koy, T. (2015). The accuracy of 3D fluoroscopy-navigated screw insertion in the upper and subaxial cervical spine. Eur. Spine J., 24 (12). S. 2967 - 2977. NEW YORK: SPRINGER. ISSN 1432-0932

Full text not available from this repository.

Abstract

Due to better primary stability and repositioning options, pedicle screws are increasingly used during posterior stabilization of the cervical spine. However, the serious risks generally associated with the insertion of screws in the cervical spine remain. The purpose of this study is to examine the accuracy of pedicle screw insertion with the use of 3D fluoroscopy navigation systems, also accounting for various spine levels. Data of 64 patients were collected during and after screw implantation (axial and subaxial) in the cervical spine. 207 screws were implanted from C1 to C7 and analyzed for placement accuracy according to postoperative CT scans and following the modified Gertzbein and Robbins classification. The accuracy of most of the inserted screws was assessed as grade 2 according to the modified Gertzbein and Robbins classification. 93.9 % of the screws implanted at C1 or C2, and 78.51 % of the screws implanted at levels C3-C7 showed placement accuracy grade 2 or better, indicating pedicle wall perforation of < 2 mm. Overall, seven complications were observed. In three cases, the vertebral artery was affected, leading to one fatality. Surgical revision was necessary once because of Magerl screw misplacement and three times due to impaired wound healing. No radicular symptoms resulted from screw malposition. Axial and subaxial screws can be inserted with a high grade of accuracy using 3D fluoroscopy-based navigation systems. Nevertheless, while this useful innovation helps to minimize the risks of misplacement, the surgery is still a challenge, as arising complications remain severe.

Item Type: Journal Article
Creators:
CreatorsEmailORCIDORCID Put Code
Bredow, J.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Oppermann, J.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Kraus, B.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Schiller, P.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Schiffer, G.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Sobottke, R.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Eysel, P.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Koy, T.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
URN: urn:nbn:de:hbz:38-385321
DOI: 10.1007/s00586-015-3974-2
Journal or Publication Title: Eur. Spine J.
Volume: 24
Number: 12
Page Range: S. 2967 - 2977
Date: 2015
Publisher: SPRINGER
Place of Publication: NEW YORK
ISSN: 1432-0932
Language: English
Faculty: Unspecified
Divisions: Unspecified
Subjects: no entry
Uncontrolled Keywords:
KeywordsLanguage
PEDICLE SCREW; COMPUTED-TOMOGRAPHY; NONTRAUMATIC LESIONS; CLINICAL ACCURACY; FREE-HAND; FIXATION; PLACEMENT; COMPLICATIONS; STABILITY; LANDMARKSMultiple languages
Clinical Neurology; OrthopedicsMultiple languages
URI: http://kups.ub.uni-koeln.de/id/eprint/38532

Downloads

Downloads per month over past year

Altmetric

Export

Actions (login required)

View Item View Item