Insertion Angle of Pedicle Screws in the Subaxial Cervical Spine: The Analysis of Computed Tomography-Navigated Insertion of Pedicle Screws

Stavros Oikonomidis; Frank Beyer; Carolin Meyer; Christoph Tobias Baltin; Peer Eysel; Jan Bredow

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자료유형: 학술저널

저자정보: Stavros Oikonomidis (University of Cologne) Frank Beyer (University of Cologne) Carolin Meyer (University of Cologne) Christoph Tobias Baltin (University of Cologne) Peer Eysel (University of Cologne) Jan Bredow (University of Cologne)

저널정보: 대한척추외과학회 Asian Spine Journal Asian Spine Journal Vol.14 No.1

발행연도: 2020.1

수록면: 66 - 71 (6page)

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Study Design: Four orthopedic spine surgeons measured the radiological parameters of pedicle screws in the cervical spine using a postoperative computed tomography (CT) scan. Purpose: This study analyzed the insertion angle of CT-navigated insertion of pedicle screws in the subaxial cervical spine and classified them according to their position. Overview of Literature: Overall, a pedicle transverse angle of 33.6°–50.2° with a mean angle of 45° relative to the midline has been reported in the literature. Methods: The insertion angles of 87 pedicle screws inserted using CT-based navigation in the subaxial cervical spine were measured in the postoperative CT. The screw positioning was determined according to the modified Gertzbein and Robbins classification. Results: Total 89.3% (n=78) of the pedicle screws inserted using CT-based navigation showed good placement. The mean insertion angle of the pedicle screws that showed good positioning was 29.9°±9.9°. The pedicle screws showing bad positioning had a mean insertion angle of 26.8°±10.5° (p=0.157). The interobserver reliability showed a reliable measurement intraclass correlation coefficient: 0.994 (95% confidence interval, 0.992–0.996). Conclusions: The present results show that the insertion angle of the pedicle screws in the subaxial cervical spine was smaller than the actual pedicle transverse angle, as per the literature. One reason for this discrepancy could be that the navigation systems allow the insertion of cervical pedicle screws with a lower convergence.

#Cervical spine #Pedicle transverse angle #Navigation #Pedicle screws #Insertion angle

참고문헌 (18)

참고문헌 신청

Abumi K / 1997 / Pedicle screw fixation for nontraumatic lesions of the cervical spine / Spine 22:1853~1863

Abumi K / 1994 / Transpedicular screw fixation for traumatic lesions of the middle and lower cervical spine : description of the techniques and preliminary report / J Spinal Disord 7:19~28

Kotani Y / 1994 / Biomechanical analysis of cervical stabilization systems : an assessment of transpedicular screw fixation in the cervical spine / Spine 19:2529~2539

Abumi K / 2000 / Complications of pedicle screw fixation in reconstructive surgery of the cervical spine / Spine 25:962~969

Ishikawa Y / 2010 / Clinical accuracy of three-dimensional fluoroscopy-based computer-assisted cervical pedicle screw placement : a retrospective comparative study of conventional versus computer-assisted cervical pedicle screw placement / J Neurosurg Spine 13:606~611

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