ArticleBMC musculoskeletal disorders2020
Risk of pedicle and spinous process violation during cortical bone trajectory screw placement in the lumbar spine.
Article in BMC musculoskeletal disorders, 2020. 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, 8 citations in OpenAlex.
- Effectiveness and safety of robot-assisted versus fluoroscopy-assisted cortical bone trajectory screw instrumentation in spinal surgery: a systematic review and meta-analysis.Journal of robotic surgery · 2024Pooled it
- Accuracy and safety of robot-assisted cortical bone trajectory screw placement: a comparison of robot-assisted technique with fluoroscopy-assisted approach.BMC musculoskeletal disorders · 2022Trial
- A comprehensive framework for planning pedicle screw trajectory using ANTs template-based registration approach.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 · 2026Article
- Extrapedicular approach for basivertebral nerve radiofrequency ablation: a conceptual review.Journal of orthopaedic surgery and research · 2026Review
- Diagnostic Performance of CT-like Images for Lumbar Pedicle Screw Planning and Spinal Canal Area Measurement: A Comparative Study with Conventional CT and MRI.Tomography (Ann Arbor, Mich.) · 2026Article
- Lumbar Pedicle Morphometry in the Mexican Population: Defining Anatomical References for Safer Spine Surgery.Cureus · 2025Article
- A 3D-CT Study of the Cortical Bone Trajectory Screw Placement Parameters Based on Lumbar CT.Orthopaedic surgery · 2024Article
- Expert consensus on the clinical application of cortical bone trajectory for lumbar pedicle screws: results from a modified Delphi study.Asian spine journal · 2024Article
- Comparison of No Tap (two-step) and tapping robotic assisted cortical bone trajectory screw insertion.Journal of robotic surgery · 2024Article
- Let's think beyond the pedicle: A biomechanical study of a new conceptual extra pedicular screw and hook construct.Journal of clinical orthopaedics and trauma · 2023Article
Corrections and comments
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Authors and funding
5 authors at 2 institutions in 1 country.
Funding
Abstract
backgroundPrevious studies have confirmed the feasibility of the cortical bone trajectory (CBT) technique. However, there are few reports on spinous process violation and screw penetration during the screw insertion. The purpose of this study was to evaluate the incidence of spinous process violation and screw penetration through the pedicle during CBT screw insertion.
methodsComputed tomography (CT) scans with normal lumbar structures were consecutively obtained and three-dimensional (3D) reconstructions of the lumbar spine were created. Bilateral CBT screw placement was simulated on each segment using a screw diameter of 4.5 mm, 5.0 mm, or 5.5 mm. Incidences of these complications were recorded and analyzed.
resultsA total of 90 patients were enrolled. Spinous process violation was observed in 68.3, 53.3, 25.5, 1.7, and 0% from L1 to L5, respectively, using 4.5 mm screws. A significant difference was found among the five segments but this was unconnected to gender or screw diameter. The incidence of screw penetration through the inner wall decreased from L1 to L4; in turn, L1 (16.7-35.5%), L2 (12.7-34.4%), L3 (2.8-23.8%) and L4 (1.1-6.7%). This trend was reversed in L5 (6.7-16.7%). Moreover, screw penetration through the outer wall was rare. The incidence of screw penetration varied with screw size as well as lumbar level, but not with gender.
conclusionsThere are more difficulties of CBT screw fixation in upper lumbar spine. The low rate of screw penetration, using 4.5 mm screws, suggests the safety for CBT fixation in the lumbar spine. Larger screws (5.0 mm or 5.5 mm) are more recommended for use in the lower lumbar spine. Moreover, CBT fixation in L5 deserves greater attention because of the unique morphology of the pedicle.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.