ArticleEuropean spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society2018
Zonal differences in risk and pattern of pedicle screw perforations in adolescent idiopathic scoliosis (AIS): a computerized tomography (CT) review of 1986 screws.
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, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 1 of them a synthesis that pooled it.
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Who cites it
5 citing papers in PubMed, 1 synthesis or guideline pooled it, 8 citations in OpenAlex.
- Assessing pedicle morphology in pediatric spinal deformity: can magnetic resonance imaging match computed tomography? A systematic review.Spine deformity · 2026Pooled it
- Characteristics of pedicle screw misplacement using freehand technique in degenerative scoliosis surgery.Archives of orthopaedic and trauma surgery · 2023Article
- Morphometric analysis of the proximal thoracic pedicles in Lenke II and IV adolescent idiopathic scoliosis: an evaluation of the feasibility for pedicle screw insertion.Spine deformity · 2021Article
- Variations in the position of the aorta and vertebral safe zones in supine, prone, and lateral decubitus for adolescent idiopathic scoliosis.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 · 2021Article
- Use of a Novel Computerized Drill for Pedicle Screw Insertion in the Thoracic and Lumbar Spine: A Cadaveric Study.International journal of spine surgery · 2019Article
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Authors and funding
2 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeTo evaluate the zonal differences in risk and pattern of pedicle screw perforations in adolescent idiopathic scoliosis (AIS) patients.
methodsThe scoliosis curves were divided into eight zones. CT scans were used to assess perforations: Grade 0, Grade 1(< 2 mm), Grade 2(2-4 mm) and Grade 3(> 4 mm). Anterior perforations were classified into Grade 0, Grade 1(< 4 mm), Grade 2(4-6 mm) and Grade 3(> 6 mm). Grade 2 and 3 (except lateral grade 2 and 3 perforation over thoracic vertebrae) were considered as 'critical perforations'.
results1986 screws in 137 patients were analyzed. The overall perforation rate was 8.4% after exclusion of the lateral perforation. The highest medial perforation rate was at the transitional proximal thoracic (PT)/main thoracic (MT) zone (6.9%), followed by concave lumbar (6.7%) and convex main thoracic (MT) zone (6.1%). The overall critical medial perforation rate was 0.9%. 33.3% occurred at convex MT and 22.2% occurred at transitional PT/MT zone. There were 39 anterior perforations (overall perforation rate of 2.0%). 43.6% occurred at transitional PT/MT zone, whereas 23.1% occurred at concave PT zone. The overall critical anterior perforation rate was 0.6%. 5/12 (41.7%) critical perforations occurred at concave PT zone, whereas four perforations occurred at the transitional PT/MT zone. There were only two symptomatic left medial grade 2 perforations (0.1%) resulting radiculopathy, occurring at the transitional main thoracic (MT)/Lumbar (L) zone.
conclusionOverall pedicle perforation rate was 8.4%. Highest rate of critical medial perforation was at the convex MT zone and the transitional PT/MT zone, whereas highest rate of critical anterior perforation was at the concave PT zone and the transitional PT/MT zone. The rate of symptomatic perforations was 0.1%.
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