Accuracy of cannulated pedicle screw versus conventional pedicle screw for extra-pedicular screw placement in dysplastic pedicles without cancellous channel in adolescent idiopathic scoliosis: a computerized tomography (CT) analysis

Lee, Chee Kean; Chan, Chris Yin Wei; Gani, Siti Mariam Abd; Kwan, Mun Keong

doi:10.1007/s00586-017-5266-5

Cited by 13 publications

(16 citation statements)

References 31 publications

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“…Different studies have proven that the use of cannulated screws in spinal surgery is an effective and reliable method [10,12,22,23]. In our study, we tried to increase our screw accuracy using cannulated iliac screws and compared them with the group in which we used classic iliac screws.…”

Section: Discussionmentioning

confidence: 99%

“…We have not found any biomechanical studies on the stability of the iliac screws. Although the cannulated screws have been shown to be more fragile than conventional screws in a biomechanical study with pedicle screws [24], no weakness has been found in clinical studies [22,23]. To avoid any breakage problem while inserting a cannulated iliac screw, we sent the cannulated taper to the end and tried to bury it in the bone tissue with only the polyaxial part of the screw outside.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Safety and accuracy of cannulated versus non-cannulated iliac screws: Cohort study

Toy¹,

Yilar²,

Zencirli³

2020

Journal of Surgery and Medicine

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Ethics Committee Approval: Ethics committee approval was not received due to the retrospective design of the study. All procedures in this study involving human participants were performed in accordance with the 1964 Helsinki Declaration and its later amendments. Etik Kurul Onayı: Etik kurul onayı çalışmanın retrospektif dizaynından dolayı alınmamıştır. İnsan katılımcıların katıldığı çalışmalardaki tüm prosedürler, 1964 Helsinki Deklarasyonu ve daha sonra yapılan değişiklikler uyarınca gerçekleştirilmiştir.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Safety and accuracy of cannulated versus non-cannulated iliac screws: Cohort study

Toy¹,

Yilar²,

Zencirli³

2020

Journal of Surgery and Medicine

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“…In order to reduce the misplacement of pedicle screws in AIS, extra-pedicle screws [20], PPSs, cannulate pedicle screws [8], intraoperative navigation, robot-assisted pedicle screws [21] and 3D-printing drill guide template [22] have been developed. Recently, some studies have reported the clinical use of cannulated pedicle screws.…”

Section: Discussionmentioning

confidence: 99%

Uniplanar cannulated pedicle screws in the correction of Lenke type 1 adolescent idiopathic scoliosis (AIS)

Zhao

Liu

Yuan

et al. 2020

Preprint

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Background In the present study, we reported the clinical use of uniplanar cannulated pedicle screws for the correction of Lenke type 1 adolescent Idiopathic scoliosis (AIS), and its safety and clinical outcomes were also evaluated. Methods 68 patients with Lenke type 1 AIS were included, among which 38 patients were treated with uniplanar cannulated screws at the concave side of periapical levels and multiaxial screws at the other levels (group A). Moreover, the remaining 30 patients were treated with all multiaxial screws (group B). The preoperative and postoperative radiographic parameters of the Lenke type 1 AIS, axial vertebral rotation, and the safety of the pedicle screws were evaluated by X-rays and computed tomography (CT). Results Preoperative data was comparable between two groups. The postoperative proximal thoracic (PT) curve, main thoracic (MT) curve, thoracolumbar/lumbar (TL/L) curve, and apical vertebral rotation were significantly improved compared with the preoperative data. The coronal correction rates in group A and B were 83% and 81.9%, respectively (P > 0.05). The derotation rates in group A and B were 60.8% and 43.2%, respectively (P < 0.05). The rotation classification in the group A was also better compared with the group B. The misplacement rate in group A and B was 7.9% and 11.8%, respectively (P < 0.05), and the total misplacement rate on the concave side (11.4%) was higher than that of convex side (8.4%). The lateral perforation was found at the concave side, while the medial perforation was found at the convex side. On the concave side, the misplacement rate in group A and B was 9.7% and 12.3%, respectively (P < 0.05). The grades 2 and 3 perforations were three (3.5%) in the group A and eight (8.2%) in the group B (P < 0.05). On the convex side, the misplacement rate in group A and B was 5.9% and 11.1%, respectively (P < 0.05). The grades 2 and 3 perforations were one (0.9%) in the group A and four (4.4%) in the group B (P < 0.05). Conclusion Collectively, uniplanar cannulated pedicle screws could effectively increase the accuracy of pedicle screws and facilitate the derotation of the apical vertebra compared with the multiaxial pedicle screws. Trial registration retrospectively registered

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“…Besides, since the vertebra becomes more concave in the upper thoracic region, misplacements may occur even though the path of the screw is prepared by tapping when the extrapedicular screw is sent. [4,6] Moreover, as the screw heads are much wider than the screw, the transverse process may turn the direction of the screw towards the lateral area when the screw heads contact with the transverse processes while the screw is advanced. However, in the presence of a guidewire, this wire will assure the direction of the screw.…”

Section: Discussionmentioning

confidence: 99%

“…Cannulated pedicle screws (CPSs) are increasingly preferred by many spinal surgeons to increase the accuracy of the screws. [ 5 , 6 ]…”

Section: Introductionmentioning

confidence: 99%

Comparison of the accuracy of the cannulated pedicle screw and the classical pedicle screw in the treatment of Scheuermann’s kyphosis: A retrospective study

Yilar

Zeynal

Toy³

et al. 2020

Jt Dis Relat Surg

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Scheuermann's kyphosis (SK) is a spinal deformity characterized by anterior angulation of more than 5 degrees in three successive vertebra, stenosis in the disc interval, irregularity, and Schmorl nodes in lateral radiography (Figure 1c, 2c). The incidence of this disease, which was first designated by Scheuermann [1] in 1921, varies between 4 to 8%. [2] As the pedicles are usually sclerotic and rotated or too narrow in adolescent spinal deformities, it is considerably challenging to place pedicle screws in these patients. [3,4] For this reason, methods that facilitate screw placement were developed to reduce complications that might develop following potentially incorrect screw placement. Cannulated pedicle screws (CPSs) are increasingly preferred by many spinal surgeons to increase the accuracy of the screws. [5,6] Cannulated pedicle screws had been previously used in adolescent idiopathic scoliosis (AIS) patients, and their effectiveness was proven. Although CPS is frequently preferred in SK and we opine that it Objectives: This study aims to investigate if use of cannulated pedicle screw (CPS) in the dysplastic pedicles in Scheuermann's kyphosis (SK) increases the accuracy rate of the screw and reduces screw-related complications. Patients and methods: This retrospective study included 21 patients (11 males, 10 females; mean age 19.1 years; range, 13 to 22 years) (550 screws) who received correction with pedicle screws due to SK deformity between May 2015 and January 2019. Between 2017 and 2018, classical pedicle screws were used in addition to CPSs in the upper thoracic region (T2, T3, T4) and thin pedicles (group 1). However, during the years 2015 to 2016, only classical pedicle screws were used for the patients who underwent posterior instrumentation for SK (group 2). Computed tomography scanning was used to investigate the accuracy of the screws. Results: There were 12 patients (316 screws) in group 1 and nine patients (234 screws) in group 2. Seventy-four (13.4%) of all screws were inserted incorrectly. Incorrect screw rate in group 1 was significantly lower than group 2; 21 (6.6%) and 53 (22.6%), respectively (p<0.001). There were no complications related to the use of CPSs after a mean follow-up of two-and-a-half years. Conclusion: The use of CPS in the surgical treatment of SK does not increase the complication rate; instead it increases the accuracy of the screw. For this reason, we believe that CPS may be an effective and reliable option in the treatment of SK.

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Accuracy of cannulated pedicle screw versus conventional pedicle screw for extra-pedicular screw placement in dysplastic pedicles without cancellous channel in adolescent idiopathic scoliosis: a computerized tomography (CT) analysis

Abstract: Usage of cannulated screw system significantly increases the accuracy of pedicle screw insertion in dysplastic pedicles in AIS.

Cited by 13 publications

References 31 publications

Safety and accuracy of cannulated versus non-cannulated iliac screws: Cohort study

Safety and accuracy of cannulated versus non-cannulated iliac screws: Cohort study

Uniplanar cannulated pedicle screws in the correction of Lenke type 1 adolescent idiopathic scoliosis (AIS)

Comparison of the accuracy of the cannulated pedicle screw and the classical pedicle screw in the treatment of Scheuermann’s kyphosis: A retrospective study

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