BACKGROUND Transarticular screw fixation is used in the upper cervical and lumbar spine to achieve posterior spinal stability, and its biomechanical performance has been proven to be similar to that of pedicle screw fixation. However, few studies have reported the use of transarticular screw fixation in the upper thoracic spine. OBJECTIVE To biomechanically compare transarticular screws with ...

OBJECTIVE To present the clinical benefits of an instrument designed to facilitate removal of polyaxial screws during revision surgery. METHODS All polyaxial screws can be removed without additional materials or a large amount of debridement using our newly designed instrument. Forty-two screws were removed from five patients without any complications using this instrument. RESULTS We remov...

The procedure for removing a broken pedicle screw should ideally be technically easy and minimally invasive, as any damage to the pedicle, during removal of the broken screw, may weaken the pedicle, thus compromising on the success of re-instrumentation. We describe the case of a 32-year old man who had undergone surgery for traumatic third lumbar vertebral body fracture three years prior to cu...

OBJECTIVE This study was conducted to compare radiologic changes and clinical outcomes in adjacent level of percutaneous pedicle screws with those of conventional (open) pedicle screws. METHODS From January 2007 to December 2009, 51 patients underwent L3-5 decompression and spinal fusion. Percutaneous pedicle screws were used in 22 patients, and open pedicle screws were used in the remaining ...

STUDY DESIGN A retrospective analysis of 1078 spinal surgical procedures with lumbar pedicle screw placement at a single institution. OBJECTIVE Based on previously established normative values, triggered electromyographic stimulation (TrgEMG) was re-examined to evaluate its efficacy in determining screw malposition. SUMMARY OF BACKGROUND DATA Threshold values for confirmation of intraosseou...

STUDY DESIGN Retrospective evaluation of complications in 180 consecutive patients with cervical disorders who had been treated by using pedicle screw fixation systems. OBJECTIVES To determine the risks associated with pedicle screw fixation in the cervical spine and to emphasize the importance of preoperative planning and surgical techniques in reducing the risks of this procedure. SUMMARY...

OBJECTIVE To evaluate the influence of pilot hole tapping on pullout resistance and insertion torque of pedicle screws with a conical core. METHODS Mechanical tests using a universal testing machine were performed on pedicle screws with a conical core that were inserted into pedicles in the fifth lumbar vertebra of calves. The insertion torque was measured using a torque meter with a capacity...

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Pedicle screw fixation in the thoracic spine presents certain challenges due to the critical regional neurovascular anatomy as well as the narrow pedicular corridor that typically exists. With increased awareness of the dangers of intraoperative radiation, the ability to place pedicle screws with anatomic landmarks alone is paramount. In this study, we reviewed the literature from 1990 to 2015 ...

STUDY DESIGN A retrospective review of charts, x-rays (XRs) and computed tomography (CT) scans was performed. OBJECTIVE To evaluate the accuracy of pedicle screw placement using a novel classification system to determine potentially significant screw misplacement. SUMMARY OF BACKGROUND DATA The accuracy rate of pedicle screw (PS) placement varies from 85% to 95% in the literature. This demo...