Cervical Pedicle Screw Placement Using Medial Funnel Technique.
10.14245/kjs.2017.14.3.84
- Author:
Jung Hwan LEE
1
;
Byung Kwan CHOI
;
In Ho HAN
;
Won Gyu CHOI
;
Kyoung Hyup NAM
;
Hwan Soo KIM
Author Information
1. Department of Neurosurgery, Pusan National University Hospital, Busan, Korea. spine@pusan.ac.kr
- Publication Type:Original Article
- Keywords:
Cervical vertebrae;
Pedicle screws;
Bone screws
- MeSH:
Bone Screws;
Cervical Vertebrae;
Diagnosis;
Female;
Humans;
Neurosurgeons;
Pedicle Screws*
- From:Korean Journal of Spine
2017;14(3):84-88
- CountryRepublic of Korea
- Language:English
-
Abstract:
OBJECTIVE: Cervical pedicle screw (CPS) placement is very challenging due to high risk of neurovascular complications. We devised a new technique (medial funnel technique) to improve the accuracy and feasibility of CPS placement. METHODS: We reviewed 28 consecutive patients undergoing CPS instrumentation using the medial funnel technique. Their mean age was 51.4 years (range, 30–81 years). Preoperative diagnosis included degenerative disease (n=5), trauma (n=22), and infection (n=1). Screw perforations were graded with the following criteria: grade 0 having no perforation, grade 1 having < 25%, grade 2 having 25%–50% and grade 3 having >50% of screw diameter. Grades 0 and 1 were considered as correct position. The degree of perforation was determined by 2 junior neurosurgeons and 1 senior neurosurgeon. RESULTS: A total of 88 CPSs were inserted. The rate of correct placement was 94.3%; grade 0, 54 screws; grade 1, 29 screws; grade 2, 4 screws; and grade 3, 1 screw. No neurovascular complications or failure of instrumentation occurred. In perforated screws (34 screws), lateral perforations were 4 and medial perforations were 30. CONCLUSION: We performed CPS insertion using medial funnel technique and achieved 94.3% (83 of 88) of correct placement. And it can decrease lateral perforation.
