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Safety and Accuracy of the Freehand Placement of C7 Pedicle Screws in Cervical and Cervicothoracic Constructs
Background: Cervical pedicle screws are advantageous in their biomechanical stability within cervical and cervicothoracic constructs. The seventh cervical vertebra contains relatively large pedicles and has a low incidence of vertebral artery localization within the transverse foramina. The freehand...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Cureus
2019
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6773450/ https://www.ncbi.nlm.nih.gov/pubmed/31592098 http://dx.doi.org/10.7759/cureus.5304 |
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author | Clifton, William Louie, Christopher Williams, David B Damon, Aaron Dove, Conrad Pichelmann, Mark |
author_facet | Clifton, William Louie, Christopher Williams, David B Damon, Aaron Dove, Conrad Pichelmann, Mark |
author_sort | Clifton, William |
collection | PubMed |
description | Background: Cervical pedicle screws are advantageous in their biomechanical stability within cervical and cervicothoracic constructs. The seventh cervical vertebra contains relatively large pedicles and has a low incidence of vertebral artery localization within the transverse foramina. The freehand technique of pedicle screw insertion is advantageous in decreasing intraoperative radiation exposure both to the patient and surgeon. In this study, we investigated the safety and accuracy of C7 pedicle screw placement at our institution utilizing an anatomic freehand technique. Methods and Materials: A retrospective study was performed, and 20 patients were identified who met the inclusion criteria over a five-year period (2013-2018). The C7 pedicle screw placement capability and accuracy were recorded. Accuracy was graded based upon postoperative imaging on a Grade 0-3 scale for breach assessment. Any neurologic complications related to screw placement were also recorded. Results: Successful pedicle screw placement occurred in 90% of attempts (36/40). The overall screw accuracy rate was 89% (32/36). There were four minor breaches (Grade 1) identified on CT, without neurologic complications. The fusion rate in our cohort for patients with follow up greater than eight months was 100%. Conclusions: In our patient series, the freehand technique of C7 pedicle screw placement utilizing a small laminotomy with direct pedicle palpation appears to be a safe and accurate method for screw placement, and provides adequate biomechanical stability for cervical and cervicothoracic construct fusion. |
format | Online Article Text |
id | pubmed-6773450 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | Cureus |
record_format | MEDLINE/PubMed |
spelling | pubmed-67734502019-10-07 Safety and Accuracy of the Freehand Placement of C7 Pedicle Screws in Cervical and Cervicothoracic Constructs Clifton, William Louie, Christopher Williams, David B Damon, Aaron Dove, Conrad Pichelmann, Mark Cureus Neurosurgery Background: Cervical pedicle screws are advantageous in their biomechanical stability within cervical and cervicothoracic constructs. The seventh cervical vertebra contains relatively large pedicles and has a low incidence of vertebral artery localization within the transverse foramina. The freehand technique of pedicle screw insertion is advantageous in decreasing intraoperative radiation exposure both to the patient and surgeon. In this study, we investigated the safety and accuracy of C7 pedicle screw placement at our institution utilizing an anatomic freehand technique. Methods and Materials: A retrospective study was performed, and 20 patients were identified who met the inclusion criteria over a five-year period (2013-2018). The C7 pedicle screw placement capability and accuracy were recorded. Accuracy was graded based upon postoperative imaging on a Grade 0-3 scale for breach assessment. Any neurologic complications related to screw placement were also recorded. Results: Successful pedicle screw placement occurred in 90% of attempts (36/40). The overall screw accuracy rate was 89% (32/36). There were four minor breaches (Grade 1) identified on CT, without neurologic complications. The fusion rate in our cohort for patients with follow up greater than eight months was 100%. Conclusions: In our patient series, the freehand technique of C7 pedicle screw placement utilizing a small laminotomy with direct pedicle palpation appears to be a safe and accurate method for screw placement, and provides adequate biomechanical stability for cervical and cervicothoracic construct fusion. Cureus 2019-08-02 /pmc/articles/PMC6773450/ /pubmed/31592098 http://dx.doi.org/10.7759/cureus.5304 Text en Copyright © 2019, Clifton et al. http://creativecommons.org/licenses/by/3.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. |
spellingShingle | Neurosurgery Clifton, William Louie, Christopher Williams, David B Damon, Aaron Dove, Conrad Pichelmann, Mark Safety and Accuracy of the Freehand Placement of C7 Pedicle Screws in Cervical and Cervicothoracic Constructs |
title | Safety and Accuracy of the Freehand Placement of C7 Pedicle Screws in Cervical and Cervicothoracic Constructs |
title_full | Safety and Accuracy of the Freehand Placement of C7 Pedicle Screws in Cervical and Cervicothoracic Constructs |
title_fullStr | Safety and Accuracy of the Freehand Placement of C7 Pedicle Screws in Cervical and Cervicothoracic Constructs |
title_full_unstemmed | Safety and Accuracy of the Freehand Placement of C7 Pedicle Screws in Cervical and Cervicothoracic Constructs |
title_short | Safety and Accuracy of the Freehand Placement of C7 Pedicle Screws in Cervical and Cervicothoracic Constructs |
title_sort | safety and accuracy of the freehand placement of c7 pedicle screws in cervical and cervicothoracic constructs |
topic | Neurosurgery |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6773450/ https://www.ncbi.nlm.nih.gov/pubmed/31592098 http://dx.doi.org/10.7759/cureus.5304 |
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