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Cadaveric study for ideal dorsal pedicle screw entry point

OBJECTIVE: To determine the entry for the dorsal pedicular screw in relation to the notch present at the junction of base of the lateral margin of superior articular process with superior border of transverse process in dorsal spine. The advantage of this technique is a constant and easily identifia...

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Autores principales: Sonone, Sandeep, Dahapute, Aditya Anand, Pal, Mahendra, Virani, Siddharth, Gala, Rohan
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Medknow Publications & Media Pvt Ltd 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5490346/
https://www.ncbi.nlm.nih.gov/pubmed/28694596
http://dx.doi.org/10.4103/jcvjs.JCVJS_5_17
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author Sonone, Sandeep
Dahapute, Aditya Anand
Pal, Mahendra
Virani, Siddharth
Gala, Rohan
author_facet Sonone, Sandeep
Dahapute, Aditya Anand
Pal, Mahendra
Virani, Siddharth
Gala, Rohan
author_sort Sonone, Sandeep
collection PubMed
description OBJECTIVE: To determine the entry for the dorsal pedicular screw in relation to the notch present at the junction of base of the lateral margin of superior articular process with superior border of transverse process in dorsal spine. The advantage of this technique is a constant and easily identifiable entry point which does not involve partial resection of the inferior facet, thus maintaining stability and maintaining the well defined transverse and sagittal screw angles and decreasing the incidence of medial and inferior pedicle violation. MATERIALS AND METHODS: The study was carried out using ten cadavers (four male and six female). Spinal column was dissected completely from cadavers. Before the experiment, normal anatomy was confirmed on all cadavers excluding cases of spinal deformity. Dissection was done by the spine surgeons taking care to preserve all the bony landmarks near the entry point. This study was carried out bilaterally on pedicles between the first and twelfth thoracic (T) vertebrae. RESULTS: The relation of the superior articular notch and transverse process to the thoracic spine pedicles was studied. It was found that superior third of the pedicle was related to the superior articular notch and the transverse process in the first five thoracic vertebrae. The relation of these structures to the pedicle of the sixth thoracic vertebra was somewhat equally distributed between the superior and middle third of the pedicle. From the 7(th) to 12(th) thoracic vertebrae the superior articular process and transverse process were related to the middle third of the pedicle in almost all the cases. It is important to note that the inferior 1/3(rd) of the pedicle was not related to these landmarks at any of the levels. CONCLUSION: We conclude that the ideal pedicle entry point described here should be considered by surgeons during thoracic pedicle screw instrumentation. The notch at the base of the superior articular process will always remain constant and therefore an important anatomical landmark in guiding the screw toward the entry of the pedicle.
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spelling pubmed-54903462017-07-10 Cadaveric study for ideal dorsal pedicle screw entry point Sonone, Sandeep Dahapute, Aditya Anand Pal, Mahendra Virani, Siddharth Gala, Rohan J Craniovertebr Junction Spine Original Article OBJECTIVE: To determine the entry for the dorsal pedicular screw in relation to the notch present at the junction of base of the lateral margin of superior articular process with superior border of transverse process in dorsal spine. The advantage of this technique is a constant and easily identifiable entry point which does not involve partial resection of the inferior facet, thus maintaining stability and maintaining the well defined transverse and sagittal screw angles and decreasing the incidence of medial and inferior pedicle violation. MATERIALS AND METHODS: The study was carried out using ten cadavers (four male and six female). Spinal column was dissected completely from cadavers. Before the experiment, normal anatomy was confirmed on all cadavers excluding cases of spinal deformity. Dissection was done by the spine surgeons taking care to preserve all the bony landmarks near the entry point. This study was carried out bilaterally on pedicles between the first and twelfth thoracic (T) vertebrae. RESULTS: The relation of the superior articular notch and transverse process to the thoracic spine pedicles was studied. It was found that superior third of the pedicle was related to the superior articular notch and the transverse process in the first five thoracic vertebrae. The relation of these structures to the pedicle of the sixth thoracic vertebra was somewhat equally distributed between the superior and middle third of the pedicle. From the 7(th) to 12(th) thoracic vertebrae the superior articular process and transverse process were related to the middle third of the pedicle in almost all the cases. It is important to note that the inferior 1/3(rd) of the pedicle was not related to these landmarks at any of the levels. CONCLUSION: We conclude that the ideal pedicle entry point described here should be considered by surgeons during thoracic pedicle screw instrumentation. The notch at the base of the superior articular process will always remain constant and therefore an important anatomical landmark in guiding the screw toward the entry of the pedicle. Medknow Publications & Media Pvt Ltd 2017 /pmc/articles/PMC5490346/ /pubmed/28694596 http://dx.doi.org/10.4103/jcvjs.JCVJS_5_17 Text en Copyright: © 2017 Journal of Craniovertebral Junction and Spine http://creativecommons.org/licenses/by-nc-sa/3.0 This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 3.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms.
spellingShingle Original Article
Sonone, Sandeep
Dahapute, Aditya Anand
Pal, Mahendra
Virani, Siddharth
Gala, Rohan
Cadaveric study for ideal dorsal pedicle screw entry point
title Cadaveric study for ideal dorsal pedicle screw entry point
title_full Cadaveric study for ideal dorsal pedicle screw entry point
title_fullStr Cadaveric study for ideal dorsal pedicle screw entry point
title_full_unstemmed Cadaveric study for ideal dorsal pedicle screw entry point
title_short Cadaveric study for ideal dorsal pedicle screw entry point
title_sort cadaveric study for ideal dorsal pedicle screw entry point
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5490346/
https://www.ncbi.nlm.nih.gov/pubmed/28694596
http://dx.doi.org/10.4103/jcvjs.JCVJS_5_17
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