Cervical Pedicle Screws Versus Lateral Mass Screws

Jones, E. L.; Heller, John G.; Silcox, Donald C.; Hutton, William

doi:10.1097/00007632-199705010-00009

Cited by 403 publications

(137 citation statements)

References 14 publications

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“…Cervical pedicle screw fixation has been shown to be the most stable form of cervical instrumentation [9,12,14]. However, due to the close proximity of the spinal cord, nerve roots and vertebral arteries, this type of surgery is generally considered too risky.…”

Section: Discussionmentioning

confidence: 99%

Placement and complications of cervical pedicle screws in 144 cervical trauma patients using pedicle axis view techniques by fluoroscope

et al. 2009

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Cervical pedicle screw fixation is an effective procedure for stabilising an unstable motion segment; however, it has generally been considered too risky due to the potential for injury to neurovascular structures, such as the spinal cord, nerve roots or vertebral arteries. Since 1995, we have treated 144 unstable cervical injury patients with pedicle screws using a fluoroscopy-assisted pedicle axis view technique. The purpose of this study was to investigate the efficacy of this technique in accurately placing pedicle screws to treat unstable cervical injuries, and the ensuing clinical outcomes and complications. The accuracy of pedicle screw placement was postoperatively examined by axial computed tomography scans and oblique radiographs. Solid posterior bony fusion without secondary dislodgement was accomplished in 96% of all cases. Of the 620 cervical pedicle screws inserted, 57 (9.2%) demonstrated screw exposure (\50% of the screw outside the pedicle) and 24 (3.9%) demonstrated pedicle perforation ([50% of the screw outside the pedicle). There was one case in which a probe penetrated a vertebral artery without further complication and one case with transient radiculopathy. Pre-and postoperative tracheotomy was required in 20 (13.9%) of the 144 patients. However, the tracheotomies were easily performed, because those patients underwent posterior surgery alone without postoperative external fixation. The placement of cervical pedicle screws using a fluoroscopy-assisted pedicle axis view technique provided good clinical results and a few complications for unstable cervical injuries, but a careful surgical procedure was needed to safely insert the screws and more improvement in imaging and navigation system is expected.

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Section: Discussionmentioning

confidence: 99%

Placement and complications of cervical pedicle screws in 144 cervical trauma patients using pedicle axis view techniques by fluoroscope

et al. 2009

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“…Because transpedicular screw fixation has been found to be effective in the stabilization of the middle and lower cervical spine, a number of studies have quantified the dimensions and angulations of the cervical pedicle [6,9,10,14,16,20]. While these studies have contributed critical information to the spinal surgeon's fund of knowledge, there has been a notable absence of research describing the shape of the cervical pedicle along its axis.…”

Section: Discussionmentioning

confidence: 99%

“…Recently, clinical studies have demonstrated the efficacy of pedicle screws for the repair of non-traumatic lesions in the middle and lower cervical spine [1][2][3][4][5]. While other techniques such as anterior plating, interspinous wiring, and lateral mass screw fixation are still being used to stabilize the cervical spine, transpedicular screw fixation has been found to confer superior levels of fixation with a reduced likelihood of hardware loosening, particularly in the repair of three-column fractures [1,8,9,11].…”

Section: Introductionmentioning

confidence: 99%

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The anatomic variability of human cervical pedicles: considerations for transpedicular screw fixation in the middle and lower cervical spine

Shin¹,

Panjabi²,

Chen³

et al. 2000

European Spine Journal

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“…6,7 Even under direct visualization in a cadaveric study or in experienced surgical hands, pedicle breaches have been reported 8% to 13% of the time. 4,8 Pedicle screw fixation in T1, in contrast, is more straightforward. Anteroposterior fluoroscopic imaging is almost always possible, and the T1 pedicle is generally large enough to instrument.…”

mentioning

confidence: 99%

A Comparison of Pedicle and Lateral Mass Screw Construct Stiffnesses at the Cervicothoracic Junction

Rhee¹,

Kraiwattanapong²,

Hutton³

2005

Spine

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C7 pedicle screw fixation provides the construct with the highest normalized stiffness for stabilizing the cervicothoracic junction. If C7 pedicle fixation is not possible, then performing two-level lateral mass fixation at C6 and C7 will achieve a construct with similar normalized stiffness except in axial compression. The addition of triple wiring to the spinous processes does not significantly increase lateral mass construct normalized stiffness.

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Cervical Pedicle Screws Versus Lateral Mass Screws

Abstract: Cervical pedicle screws demonstrated a significantly higher resistance to pull-out forces than did lateral mass screws. The variability in pedicle morphometry and orientation requires careful preoperative assessment to determine the suitability of pedicle screw insertion.

Cited by 403 publications

References 14 publications

Placement and complications of cervical pedicle screws in 144 cervical trauma patients using pedicle axis view techniques by fluoroscope

Placement and complications of cervical pedicle screws in 144 cervical trauma patients using pedicle axis view techniques by fluoroscope

The anatomic variability of human cervical pedicles: considerations for transpedicular screw fixation in the middle and lower cervical spine

A Comparison of Pedicle and Lateral Mass Screw Construct Stiffnesses at the Cervicothoracic Junction

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