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

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 treat... Full description

Journal Title: European spine journal 2009-06-02, Vol.18 (9), p.1293-1299
Main Author: Yukawa, Yasutsugu
Other Authors: Kato, Fumihiko , Ito, Keigo , Horie, Yumiko , Hida, Tetsurou , Nakashima, Hiroaki , Machino, Masaaki
Format: Electronic Article Electronic Article
Language: English
Subjects:
Publisher: Berlin/Heidelberg: Springer-Verlag
ID: ISSN: 0940-6719
Link: https://www.ncbi.nlm.nih.gov/pubmed/19488794
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recordid: cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_2899535
title: Placement and complications of cervical pedicle screws in 144 cervical trauma patients using pedicle axis view techniques by fluoroscope
format: Article
creator:
  • Yukawa, Yasutsugu
  • Kato, Fumihiko
  • Ito, Keigo
  • Horie, Yumiko
  • Hida, Tetsurou
  • Nakashima, Hiroaki
  • Machino, Masaaki
subjects:
  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Bone Screws
  • Cervical spine
  • Cervical trauma
  • Cervical Vertebrae - diagnostic imaging
  • Cervical Vertebrae - injuries
  • Cervical Vertebrae - surgery
  • Complications
  • Dislocation
  • Electronics in navigation
  • Equipment Failure
  • Female
  • Fluoroscopy - methods
  • Fracture
  • Humans
  • Joint Dislocations - diagnostic imaging
  • Joint Dislocations - pathology
  • Joint Dislocations - surgery
  • Magnetic Resonance Imaging
  • Male
  • Medicine
  • Medicine & Public Health
  • Methods
  • Middle Aged
  • Neck Injuries - diagnostic imaging
  • Neck Injuries - pathology
  • Neck Injuries - surgery
  • Neuronavigation - methods
  • Neurosurgery
  • Original
  • Original Article
  • Outcome Assessment (Health Care) - methods
  • Pedicle axis view
  • Pedicle screw fixation
  • Placement
  • Postoperative Complications - etiology
  • Postoperative Period
  • Preoperative Care
  • Prosthesis Implantation - instrumentation
  • Prosthesis Implantation - methods
  • Spinal Fractures - diagnostic imaging
  • Spinal Fractures - pathology
  • Spinal Fractures - surgery
  • Spinal Fusion - instrumentation
  • Spinal Fusion - methods
  • Spinal Injuries - diagnostic imaging
  • Spinal Injuries - pathology
  • Spinal Injuries - surgery
  • Surgical Orthopedics
  • Tomography, X-Ray Computed - methods
  • Treatment Outcome
  • Young Adult
ispartof: European spine journal, 2009-06-02, Vol.18 (9), p.1293-1299
description: 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). 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.
language: eng
source:
identifier: ISSN: 0940-6719
fulltext: no_fulltext
issn:
  • 0940-6719
  • 1432-0932
url: Link


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titlePlacement and complications of cervical pedicle screws in 144 cervical trauma patients using pedicle axis view techniques by fluoroscope
creatorYukawa, Yasutsugu ; Kato, Fumihiko ; Ito, Keigo ; Horie, Yumiko ; Hida, Tetsurou ; Nakashima, Hiroaki ; Machino, Masaaki
creatorcontribYukawa, Yasutsugu ; Kato, Fumihiko ; Ito, Keigo ; Horie, Yumiko ; Hida, Tetsurou ; Nakashima, Hiroaki ; Machino, Masaaki
descriptionCervical 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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languageeng
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subjectAdolescent ; Adult ; Aged ; Aged, 80 and over ; Bone Screws ; Cervical spine ; Cervical trauma ; Cervical Vertebrae - diagnostic imaging ; Cervical Vertebrae - injuries ; Cervical Vertebrae - surgery ; Complications ; Dislocation ; Electronics in navigation ; Equipment Failure ; Female ; Fluoroscopy - methods ; Fracture ; Humans ; Joint Dislocations - diagnostic imaging ; Joint Dislocations - pathology ; Joint Dislocations - surgery ; Magnetic Resonance Imaging ; Male ; Medicine ; Medicine & Public Health ; Methods ; Middle Aged ; Neck Injuries - diagnostic imaging ; Neck Injuries - pathology ; Neck Injuries - surgery ; Neuronavigation - methods ; Neurosurgery ; Original ; Original Article ; Outcome Assessment (Health Care) - methods ; Pedicle axis view ; Pedicle screw fixation ; Placement ; Postoperative Complications - etiology ; Postoperative Period ; Preoperative Care ; Prosthesis Implantation - instrumentation ; Prosthesis Implantation - methods ; Spinal Fractures - diagnostic imaging ; Spinal Fractures - pathology ; Spinal Fractures - surgery ; Spinal Fusion - instrumentation ; Spinal Fusion - methods ; Spinal Injuries - diagnostic imaging ; Spinal Injuries - pathology ; Spinal Injuries - surgery ; Surgical Orthopedics ; Tomography, X-Ray Computed - methods ; Treatment Outcome ; Young Adult
ispartofEuropean spine journal, 2009-06-02, Vol.18 (9), p.1293-1299
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1Kato, Fumihiko
2Ito, Keigo
3Horie, Yumiko
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5Nakashima, Hiroaki
6Machino, Masaaki
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descriptionCervical 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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3Aged, 80 and over
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7Cervical Vertebrae - diagnostic imaging
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12Electronics in navigation
13Equipment Failure
14Female
15Fluoroscopy - methods
16Fracture
17Humans
18Joint Dislocations - diagnostic imaging
19Joint Dislocations - pathology
20Joint Dislocations - surgery
21Magnetic Resonance Imaging
22Male
23Medicine
24Medicine & Public Health
25Methods
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27Neck Injuries - diagnostic imaging
28Neck Injuries - pathology
29Neck Injuries - surgery
30Neuronavigation - methods
31Neurosurgery
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34Outcome Assessment (Health Care) - methods
35Pedicle axis view
36Pedicle screw fixation
37Placement
38Postoperative Complications - etiology
39Postoperative Period
40Preoperative Care
41Prosthesis Implantation - instrumentation
42Prosthesis Implantation - methods
43Spinal Fractures - diagnostic imaging
44Spinal Fractures - pathology
45Spinal Fractures - surgery
46Spinal Fusion - instrumentation
47Spinal Fusion - methods
48Spinal Injuries - diagnostic imaging
49Spinal Injuries - pathology
50Spinal Injuries - surgery
51Surgical Orthopedics
52Tomography, X-Ray Computed - methods
53Treatment Outcome
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titlePlacement and complications of cervical pedicle screws in 144 cervical trauma patients using pedicle axis view techniques by fluoroscope
authorYukawa, Yasutsugu ; Kato, Fumihiko ; Ito, Keigo ; Horie, Yumiko ; Hida, Tetsurou ; Nakashima, Hiroaki ; Machino, Masaaki
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8Cervical Vertebrae - injuries
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12Electronics in navigation
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41Prosthesis Implantation - instrumentation
42Prosthesis Implantation - methods
43Spinal Fractures - diagnostic imaging
44Spinal Fractures - pathology
45Spinal Fractures - surgery
46Spinal Fusion - instrumentation
47Spinal Fusion - methods
48Spinal Injuries - diagnostic imaging
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atitlePlacement and complications of cervical pedicle screws in 144 cervical trauma patients using pedicle axis view techniques by fluoroscope
jtitleEuropean spine journal
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abstractCervical 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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pmid19488794
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