Universität zu Köln

Bredow, Jan, Meyer, C., Siedek, F., Neiss, W. F., Loehrer, L., Mueller, L. P., Eysel, P. and Stein, G. (2017). Accuracy of 3D fluoro-navigated anterior transpedicular screws in the subaxial cervical spine: an experimental study on human specimens. Eur. Spine J., 26 (11). S. 2934 - 2941. NEW YORK: SPRINGER. ISSN 1432-0932

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Abstract

Pedicle screw stabilization, the standard technique in the thoracic and lumbar spine, is increasingly used in the cervical spine. Initial studies on the use of anterior pedicle screws (ATPS) in the cervical spine have been recently published. ATPS use has theoretical advantages over posterior stabilization. We have already established a 3D-fluoroscopy navigation setup in a study of artificial bones. The aim of the current study was to evaluate the positioning quality/accuracy of ATPS introduced to human specimens. 36 cannulated screws (3.5 mm) were implanted anteriorly into the C3-C7 segments of four spines (unfixed, frozen, cadaveric specimens) using a 3D-fluoroscopy navigation system. Placement accuracy was evaluated using a recently published classification on postoperative CT scans. Grade 1 is perfect position with pedicle wall perforation < 1 mm, grade 2 is perforation < 2 mm, etc., and finally grade 5 is cortical perforation of > 4 mm and/or transverse foramen entry. 36 anterior pedicle screws were inserted into four human cervical spine specimens. Of these, seven screws were introduced to C3, five to C4 and eight each to C5, C6, and C7. Classified with the modified G&R, 21 of 36 (58.3%) were grade 1. Ten screws (27.8%) were grade 2. Grade 4 was assessed for two screws and grade 5 for three. Customary good positioning, combining grades 1 and 2, was thus found in 86.1%. Five screws (13.9%) did not meet this criterion (grade ae<yen>3). With 86.1% of good positioning (grade 2 or better), a 3D-fluoroscopy navigation of ATPS screws into human c-spine specimens achieved a satisfying results. These are at least comparable to results presented in the literature for posteriorly introduced subaxial pedicle screws.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Bredow, Jan UNSPECIFIED UNSPECIFIED UNSPECIFIED Meyer, C. UNSPECIFIED UNSPECIFIED UNSPECIFIED Siedek, F. UNSPECIFIED UNSPECIFIED UNSPECIFIED Neiss, W. F. UNSPECIFIED UNSPECIFIED UNSPECIFIED Loehrer, L. UNSPECIFIED UNSPECIFIED UNSPECIFIED Mueller, L. P. UNSPECIFIED UNSPECIFIED UNSPECIFIED Eysel, P. UNSPECIFIED UNSPECIFIED UNSPECIFIED Stein, G. UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-212782
DOI:	10.1007/s00586-017-5238-9
Journal or Publication Title:	Eur. Spine J.
Volume:	26
Number:	11
Page Range:	S. 2934 - 2941
Date:	2017
Publisher:	SPRINGER
Place of Publication:	NEW YORK
ISSN:	1432-0932
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language PEDICLE SCREW; POSTERIOR INSTRUMENTATION; CLINICAL ARTICLE; FIXATION; COMPLICATIONS; PLACEMENT; INSERTION; MULTICENTER; CORPECTOMY; SURGERY Multiple languages Clinical Neurology; Orthopedics Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/21278