Free-hand technique of C7 pedicle screw insertion using a simply defined entry point without fluoroscopic guidance for cervical spondylotic myelopathy patients with C3 to C6 instrumented by lateral mass screws : a retrospective cohort study
© 2024. The Author(s)..
BACKGROUND: Nowadays, both lateral mass screw (LMS) and pedicle screw were effective instrumentation for posterior stabilization of cervical spine. This study aims to evaluate the feasibility of a new free-hand technique of C7 pedicle screw insertion without fluoroscopic guidance for cervical spondylotic myelopathy (CSM) patients with C3 to C6 instrumented by lateral mass screws.
METHODS: A total of 53 CSM patients underwent lateral mass screws instrumentation at C3 to C6 levels and pedicle screw instrumentation at C7 level were included. The preoperative 3-dimenional computed tomography (CT) reconstruction images of cervical spine were used to determine 2 different C7 pedicle screw trajectories. Trajectory A passed through the axis of the C7 pedicle while trajectory B selected the midpoint of the base of C7 superior facet as the entry point. All these 53 patients had the C7 pedicle screw inserted through trajectory B by free-hand without fluoroscopic guidance and the postoperative CT images were obtained to evaluate the accuracy of C7 pedicle screw insertion.
RESULTS: Trajectory B had smaller transverse angle, smaller screw length, and smaller screw width but both similar sagittal angle and similar pedicle height when compared with trajectory A. A total of 106 pedicle screws were inserted at C7 through trajectory B and only 8 screws were displaced with the accuracy of screw placement as high as 92.5%.
CONCLUSION: In CSM patients with C3 to C6 instrumented by LMS, using trajectory B for C7 pedicle screw insertion is easy to both identify the entry point and facilitate the rod insertion.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2024 |
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| Erschienen: |
2024 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:24 |
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| Enthalten in: |
BMC surgery - 24(2024), 1 vom: 29. Feb., Seite 74 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Jiang, Jun [VerfasserIn] |
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| Links: |
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| Themen: |
Cervical |
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| Anmerkungen: |
Date Completed 04.03.2024 Date Revised 04.03.2024 published: Electronic Citation Status MEDLINE |
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| doi: |
10.1186/s12893-024-02358-7 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM369144406 |
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| 245 | 1 | 0 | |a Free-hand technique of C7 pedicle screw insertion using a simply defined entry point without fluoroscopic guidance for cervical spondylotic myelopathy patients with C3 to C6 instrumented by lateral mass screws |b a retrospective cohort study |
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| 500 | |a Date Revised 04.03.2024 | ||
| 500 | |a published: Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a © 2024. The Author(s). | ||
| 520 | |a BACKGROUND: Nowadays, both lateral mass screw (LMS) and pedicle screw were effective instrumentation for posterior stabilization of cervical spine. This study aims to evaluate the feasibility of a new free-hand technique of C7 pedicle screw insertion without fluoroscopic guidance for cervical spondylotic myelopathy (CSM) patients with C3 to C6 instrumented by lateral mass screws | ||
| 520 | |a METHODS: A total of 53 CSM patients underwent lateral mass screws instrumentation at C3 to C6 levels and pedicle screw instrumentation at C7 level were included. The preoperative 3-dimenional computed tomography (CT) reconstruction images of cervical spine were used to determine 2 different C7 pedicle screw trajectories. Trajectory A passed through the axis of the C7 pedicle while trajectory B selected the midpoint of the base of C7 superior facet as the entry point. All these 53 patients had the C7 pedicle screw inserted through trajectory B by free-hand without fluoroscopic guidance and the postoperative CT images were obtained to evaluate the accuracy of C7 pedicle screw insertion | ||
| 520 | |a RESULTS: Trajectory B had smaller transverse angle, smaller screw length, and smaller screw width but both similar sagittal angle and similar pedicle height when compared with trajectory A. A total of 106 pedicle screws were inserted at C7 through trajectory B and only 8 screws were displaced with the accuracy of screw placement as high as 92.5% | ||
| 520 | |a CONCLUSION: In CSM patients with C3 to C6 instrumented by LMS, using trajectory B for C7 pedicle screw insertion is easy to both identify the entry point and facilitate the rod insertion | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Cervical | |
| 650 | 4 | |a Computed tomography | |
| 650 | 4 | |a Pedicle screw | |
| 650 | 4 | |a Trajectory | |
| 700 | 1 | |a Song, Chen-Yu |e verfasserin |4 aut | |
| 700 | 1 | |a Wu, Zheng-Zheng |e verfasserin |4 aut | |
| 700 | 1 | |a Xie, Zuo-Zhi |e verfasserin |4 aut | |
| 700 | 1 | |a Shi, Bo |e verfasserin |4 aut | |
| 700 | 1 | |a Xu, Tao |e verfasserin |4 aut | |
| 700 | 1 | |a Wang, Han |e verfasserin |4 aut | |
| 700 | 1 | |a Qiu, Yong |e verfasserin |4 aut | |
| 700 | 1 | |a Wang, Bin |e verfasserin |4 aut | |
| 700 | 1 | |a Zhu, Ze-Zhang |e verfasserin |4 aut | |
| 700 | 1 | |a Yu, Yang |e verfasserin |4 aut | |
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