ArticleEuropean spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society2017
Screw perforation rates in 359 consecutive patients receiving computer-guided pedicle screw insertion along the cervical to lumbar spine.
Article in European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 1 of them a synthesis that pooled it.
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Who cites it
10 citing papers in PubMed, 1 synthesis or guideline pooled it, 20 citations in OpenAlex.
- Accuracy and safety of C2 pedicle or pars screw placement: a systematic review and meta-analysis.Journal of orthopaedic surgery and research · 2020Pooled it
- 3D rapid prototyping curve-specific scoliosis model: an affordable approach to reduce medial pedicle screw perforation in the thoracic and lumbar spine.Spine deformity · 2025Article
- Intraoperative-CT-navigated percutaneous posterior positioning of pedicle screws in the cervical spine.Brain & spine · 2025Article
- The Impact of Navigation in Lumbar Spine Surgery: A Study of Historical Aspects, Current Techniques and Future Directions.Journal of clinical medicine · 2024Review
- Comparison of iCT-based navigation and fluoroscopic-guidance for atlantoaxial screw placement in 78 patients with traumatic cervical spine injuries.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2024Article
- The Clinical Impact of Image Guidance and Robotics in Spinal Surgery: A Review of Safety, Accuracy, Efficiency, and Complication Reduction.International journal of spine surgery · 2021Review
- A minimally invasive, 3D-fluoroscopy-navigation-guided, 3D-controlled pedicle approach in spine surgery: first reliable results and impact on patient safety.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2021Article
- Cervical Spondylopathy and Lumbar Intervertebral Disc Herniation Coexist in Free Radical Metabolism and Focus Separation in the Body.Journal of healthcare engineering · 2021Article
- Design and application of subaxial cervical pedicle screw placement guide device.Experimental and therapeutic medicine · 2019Article
- Three-Dimensional Printed Model-Assisted Screw Installation in Treating Posterior Atlantoaxial Internal Fixation.Scientific reports · 2018Article
Corrections and comments
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Authors and funding
6 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposePedicle screw (PS) insertion has been criticized for its risk of serious injury to neurovascular structures. Although computed tomography (CT)-based navigation has been developed to avoid such complications, perforation remains an issue, even with the aid of additional guidance. We clarify screw perforation rate and direction in 359 consecutive patients treated using CT-based PS insertion and present important considerations for more accurate screw placement.
methodsThe medical records of 359 consecutive patients who underwent PS insertion involving C2-L5 using a CT-based navigation system were reviewed. Postoperative CT images were analyzed to evaluate the accuracy of screw placement. We investigated both rate and direction of screw perforation according to vertebral level.
resultsOf the 3413 PS that were inserted, 6.9% were judged as Grade 2 or 3 perforations. The combined rate of these perforations was 5.0% for C2, 11.4% for C3-5, 7.0% for C6-7, 10.4% for T1-4, 8.8% for T5-8, 4.5% for T9-12, and 3.8% for L1-5. We also analyzed the odds ratio (OR) for screw perforation in vertebrae accounting for the effects of age and disease. Multivariate analysis identified that PS insertions at C3-5 (OR 2.9, 95% CI 1.6-5.1; p < 0.001), T1-4 (OR 2.7, 95% CI 1.6-4.7; p < 0.001), and T5-8 (OR 2.3; 95% CI 1.4-3.8; p = 0.001) were significantly associated with Grade 2 or 3 screw perforation as compared with that of L1-5.
conclusionsEven with CT-based navigation, careful insertion of PS is needed in the middle cervical spine because of a significantly higher perforation rate as compared with the lumbar region.
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