Free-hand placement of high thoracic pedicle screws with the aid of fluoroscopy: evaluation of positioning by CT scans in a four-year consecutive series

Arquivos de Neuro-Psiquiatria

Bruno Perocco Braga²  Josaphat Vilela De Morais¹  Marcelo Duarte Vilela¹ 

[1] ,Hospital Mater DeiBelo Horizonte MG ,Brazil

关键词: pedicle screws;    transpedicular fixation;    thoracic spine;    cervicothoracic junction;    spinal instability;    parafusos pediculares;    fixação transpedicular;    coluna torácica alta;    junção cervico-torácica;    instabilidade espinhal;   

DOI  :  10.1590/S0004-282X2010000300012

来源: SciELO

【 摘 要 】

OBJECTIVE: To evaluate the feasibility, safety and accuracy of pedicle screw placement in the upper thoracic spine using the free-hand technique with the aid of fluoroscopy; to analyze the methods used to verify correct screw positioning intra and postoperatively. METHOD: All patients with instability of the cervicothoracic or upper thoracic spine and at least one screw placed in the segment T1-T6 as part of a posterior construct entered the study. Only C-arm intraoperative fluoroscopy was used to guide screw placement. RESULTS: We obtained excellent positioning in 98.07% of the screws. CT scans precisely demonstrated pedicle wall and anterolateral body violations. There was no hardware failure, no neurological or vascular injury and no loss of alignment during the follow-up period. CONCLUSION: Pedicle screws can be safely placed in the upper thoracic spine when strict technical principles are followed. Only a CT scan can precisely demonstrate vertebral body and medial pedicle cortical violations.

【 授权许可】

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