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Medial Pedicle Pivot Point Using Preoperative Computed Tomography Morphometric Measurements for Cervical Pedicle Screw Insertion: A Novel Technique and Case Series

This study describes a new and safe freehand cervical pedicle screw insertion technique using preoperative computed tomography (CT) morphometric measurements as a guide and a medial pedicle pivot point (MPPP) during the procedure. This study included 271 pedicles at 216 cervical spine levels (mean:...

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Autores principales: Kwon, Ji-Won, Arreza, Edward O., Suguitan, Anthony A., Lee, Soo-Bin, Sung, Sahyun, Park, Yung, Ha, Joong-Won, Kim, Tae Hyung, Moon, Seong-Hwan, Lee, Byung Ho
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8779533/
https://www.ncbi.nlm.nih.gov/pubmed/35054092
http://dx.doi.org/10.3390/jcm11020396
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author Kwon, Ji-Won
Arreza, Edward O.
Suguitan, Anthony A.
Lee, Soo-Bin
Sung, Sahyun
Park, Yung
Ha, Joong-Won
Kim, Tae Hyung
Moon, Seong-Hwan
Lee, Byung Ho
author_facet Kwon, Ji-Won
Arreza, Edward O.
Suguitan, Anthony A.
Lee, Soo-Bin
Sung, Sahyun
Park, Yung
Ha, Joong-Won
Kim, Tae Hyung
Moon, Seong-Hwan
Lee, Byung Ho
author_sort Kwon, Ji-Won
collection PubMed
description This study describes a new and safe freehand cervical pedicle screw insertion technique using preoperative computed tomography (CT) morphometric measurements as a guide and a medial pedicle pivot point (MPPP) during the procedure. This study included 271 pedicles at 216 cervical spine levels (mean: 4.75 pedicles per patient). A pedicle diameter (PD) ≥ 3.5 mm was the cut-off for pedicle screw fixation. The presence and grade of perforation were detected using postoperative CT scans, where perforations were graded as follows: 0, no perforation; 1, perforation < 0.875 mm; 2, perforation 0.875–1.75 mm; and 3, perforation > 1.75 mm. The surgical technique involved the use of an MPPP, which was the point at which the lines representing the depth of the lateral mass and total length of the pedicle intersected, deep in the lateral mass. The overall success rate was 96.3% (261/271, Grade 0 or 1 perforations). In total, 54 perforations occurred, among which 44 (81.5%) were Grade 1 and 10 (18.5%) were Grade 2. The most common perforation direction was medial (39/54, 72.2%). The freehand technique for cervical pedicle screw fixation using the MPPP may allow for a safe and accurate procedure in patients with a PD ≥3.5 mm.
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spelling pubmed-87795332022-01-22 Medial Pedicle Pivot Point Using Preoperative Computed Tomography Morphometric Measurements for Cervical Pedicle Screw Insertion: A Novel Technique and Case Series Kwon, Ji-Won Arreza, Edward O. Suguitan, Anthony A. Lee, Soo-Bin Sung, Sahyun Park, Yung Ha, Joong-Won Kim, Tae Hyung Moon, Seong-Hwan Lee, Byung Ho J Clin Med Article This study describes a new and safe freehand cervical pedicle screw insertion technique using preoperative computed tomography (CT) morphometric measurements as a guide and a medial pedicle pivot point (MPPP) during the procedure. This study included 271 pedicles at 216 cervical spine levels (mean: 4.75 pedicles per patient). A pedicle diameter (PD) ≥ 3.5 mm was the cut-off for pedicle screw fixation. The presence and grade of perforation were detected using postoperative CT scans, where perforations were graded as follows: 0, no perforation; 1, perforation < 0.875 mm; 2, perforation 0.875–1.75 mm; and 3, perforation > 1.75 mm. The surgical technique involved the use of an MPPP, which was the point at which the lines representing the depth of the lateral mass and total length of the pedicle intersected, deep in the lateral mass. The overall success rate was 96.3% (261/271, Grade 0 or 1 perforations). In total, 54 perforations occurred, among which 44 (81.5%) were Grade 1 and 10 (18.5%) were Grade 2. The most common perforation direction was medial (39/54, 72.2%). The freehand technique for cervical pedicle screw fixation using the MPPP may allow for a safe and accurate procedure in patients with a PD ≥3.5 mm. MDPI 2022-01-13 /pmc/articles/PMC8779533/ /pubmed/35054092 http://dx.doi.org/10.3390/jcm11020396 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Kwon, Ji-Won
Arreza, Edward O.
Suguitan, Anthony A.
Lee, Soo-Bin
Sung, Sahyun
Park, Yung
Ha, Joong-Won
Kim, Tae Hyung
Moon, Seong-Hwan
Lee, Byung Ho
Medial Pedicle Pivot Point Using Preoperative Computed Tomography Morphometric Measurements for Cervical Pedicle Screw Insertion: A Novel Technique and Case Series
title Medial Pedicle Pivot Point Using Preoperative Computed Tomography Morphometric Measurements for Cervical Pedicle Screw Insertion: A Novel Technique and Case Series
title_full Medial Pedicle Pivot Point Using Preoperative Computed Tomography Morphometric Measurements for Cervical Pedicle Screw Insertion: A Novel Technique and Case Series
title_fullStr Medial Pedicle Pivot Point Using Preoperative Computed Tomography Morphometric Measurements for Cervical Pedicle Screw Insertion: A Novel Technique and Case Series
title_full_unstemmed Medial Pedicle Pivot Point Using Preoperative Computed Tomography Morphometric Measurements for Cervical Pedicle Screw Insertion: A Novel Technique and Case Series
title_short Medial Pedicle Pivot Point Using Preoperative Computed Tomography Morphometric Measurements for Cervical Pedicle Screw Insertion: A Novel Technique and Case Series
title_sort medial pedicle pivot point using preoperative computed tomography morphometric measurements for cervical pedicle screw insertion: a novel technique and case series
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8779533/
https://www.ncbi.nlm.nih.gov/pubmed/35054092
http://dx.doi.org/10.3390/jcm11020396
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