Transpedicle Instrumentation in the Degenerative Spine

Heim, Stephen E.

doi:10.1097/00003086-199704000-00012

Cited by 18 publications

(13 citation statements)

References 91 publications

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“…After pedicle screw fixation became widely accepted and popular, the incidence of spinal fusion using transpedicular instrumentation has increased tremendously over the past two decades [3,6,9,14,15,18,21]. Spinal fusion using pedicle screws has many advantages over other internal fixators in biomechanical properties, fusion rate, early mobilisation and versatility [7]. But, pedicle screw fixation has its own risks, so that spinal fixation using pedicle screws is technically demanding [2,5,7,10,12,13] and many reports have been published about complications following transpedicular instrumentation [2,4,6,17,20].…”

Section: Discussionmentioning

confidence: 99%

“…Spinal fusion using pedicle screws has many advantages over other internal fixators in biomechanical properties, fusion rate, early mobilisation and versatility [7]. But, pedicle screw fixation has its own risks, so that spinal fixation using pedicle screws is technically demanding [2,5,7,10,12,13] and many reports have been published about complications following transpedicular instrumentation [2,4,6,17,20]. Facet joint violation by pedicle screw at the proximal adjacent segment is one of these complications.…”

Section: Discussionmentioning

confidence: 99%

“…The transpedicular instrumentation technique must leave the facet joints adjacent to the top screw level intact. If not, an abnormal, alternate path of loading is established which makes the adjacent segment worse [7,19,21,22]. Accelerated degeneration of the adjacent segment is a factor of postoperative back pain which makes the operative results poor.…”

Section: Discussionmentioning

confidence: 99%

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Facet joint violation during pedicle screw insertion: a cadaveric study of the adult lumbosacral spine comparing the two pedicle screw insertion techniques

Chung¹,

Suh²,

Swapnil³

et al. 2006

International Orthopaedics (SICO

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This article analyses the incidence of facet joint violation by pedicle screws inserted via the two most commonly used techniques, intersection and mammillary. Pedicle screws were inserted on each side of fresh-frozen human cadevaric specimen lumbosacral spines using the two techniques. All facet joints which were violated were found to be on the right side, where the mamillary process technique was employed. The incidence of facet joint violation was higher in the mammillary technique, which was statistically significant. The intersection technique appears to be safer than the mamillary with respect to violation of the adjacent superior facet joint.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Facet joint violation during pedicle screw insertion: a cadaveric study of the adult lumbosacral spine comparing the two pedicle screw insertion techniques

Chung¹,

Suh²,

Swapnil³

et al. 2006

International Orthopaedics (SICO

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“…The technique has been widely used for various indications. The superiority of pedicle screw fixation in biomechanical properties, fusion rate, early mobilisation and versatility has been shown conclusively [8]. Presently, pedicle screw fixation represents the so-called gold standard of spinal internal fixation [6].…”

Section: Introductionmentioning

confidence: 98%

“…Presently, pedicle screw fixation represents the so-called gold standard of spinal internal fixation [6]. However, the use of pedicle screws is technically demanding and associated with certain risks [2,5,6,8,11,12,13]. We performed a retrospective analysis of the complications of pedicle screw fixation in a consecutive series of patients operated on by the same surgeon (R.C.…”

Section: Introductionmentioning

confidence: 99%

Complications of pedicle screws in lumbar and lumbosacral fusions in 105 consecutive primary operations

2002

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Pedicle screw fixation is technically demanding and associated with high complication rates. The aim of this study was to identify and quantify the pedicle screw-related complications in 105 consecutive operations. We retrospectively analysed 105 consecutive primary operations. We found complications of varying severity in 54% of the patients. Deep infections were found in 4.7%, all successfully cured by debridement and antibiotics. There were no permanent neurological complications related to the screws. One serious neurological sequela, a T10 paraplegia, was unrelated to screw placement between L3 and S1. Screw misplacement was found in 6.5% of the screws. Screw breakage occurred in 12.4% of the patients, inevitably leading to loss of correction. Reduced spondylolisthesis L5-S1 without anterior support was found to be especially prone to screw breakage. The study confirmed that pedicle screw placement is a technically demanding procedure with a high complication rate. Fortunately, most complications are not severe. Infections can be dealt with by thorough debridement and parenteral antibiotics. Neurological sequelae can be minimised by careful tactile technique. To avoid screw breakage and subsequent loss of correction, anterior support should be provided, through either posterior or anterior lumbar interbody fusion (PLIF or ALIF) techniques, in reduced spondylolisthesis L5-S1.

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Optimal surgical planning guidance for lumbar spinal fusion considering operational safety and vertebra–screw interface strength

Lee

Kim

et al. 2012

Robotics Computer Surgery

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Transpedicle Instrumentation in the Degenerative Spine

Cited by 18 publications

References 91 publications

Facet joint violation during pedicle screw insertion: a cadaveric study of the adult lumbosacral spine comparing the two pedicle screw insertion techniques

Facet joint violation during pedicle screw insertion: a cadaveric study of the adult lumbosacral spine comparing the two pedicle screw insertion techniques

Complications of pedicle screws in lumbar and lumbosacral fusions in 105 consecutive primary operations

Optimal surgical planning guidance for lumbar spinal fusion considering operational safety and vertebra–screw interface strength

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