Evidence map›Paper›PMID 40464938›Full record

ArticleEuropean spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society2025

Accuracy of cervical pedicle screw placement using a patient-specific template guide system and risk factor analysis for screw perforation: CT-based evaluation of 437 screws.

Akira Fukushima, Itaru Oda, Hiroyuki Hasebe, Hirohito Takeuchi, Shigeki Oshima, Ryo Fujita, Hiroki Tanaka, Masanori Fujiya

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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, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

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2citing papers in PubMed
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1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

8 authors.

Akira FukushimaHokkaido Orthopaedic Memorial Hospital, Sapporo, Japan. 621akira.fuku@gmail.com.
Itaru OdaHokkaido Orthopaedic Memorial Hospital, Sapporo, Japan. odaitr@aol.com.
Hiroyuki HasebeHokkaido Orthopaedic Memorial Hospital, Sapporo, Japan.
Hirohito TakeuchiHokkaido Orthopaedic Memorial Hospital, Sapporo, Japan.
Shigeki OshimaHokkaido Orthopaedic Memorial Hospital, Sapporo, Japan.
Ryo FujitaHokkaido University Hospital, Sapporo, Japan.
Hiroki TanakaKyushu Rosai Hospital, Kitakyushu, Japan.
Masanori FujiyaHokkaido Orthopaedic Memorial Hospital, Sapporo, Japan.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeCervical pedicle screws (CPS) inserted with template-guided systems (TGS) have a low perforation rate. However, only a few case studies have been reported, and the risk factors for perforation remain unknown. This study aimed to evaluate the accuracy of CPS placement using TGS in a large case series and analyze the risk factors for CPS perforation.

methodsThis was a retrospective clinical evaluation of prospectively enrolled patients. Eighty consecutive patients who underwent CPS insertion using TGS were included in the study. Overall, 437 CPS were inserted using TGS. Computed tomography was used to evaluate CPS positions and radiographic parameters of CPS and vertebrae. Furthermore, comparisons of patient background factors and radiographic parameters were performed between the perforated and non-perforated screw groups.

resultsA total of 413 (94.5%) screws were completely inside the pedicle, 22 (5.0%) screws deviated by < 2 mm, and 2 (0.5%) screws deviated by > 2 mm and < 4 mm. Therefore, 435 (99.5%) screws were considered clinically acceptable. The perforation rate was the highest in C4 (12.5%). No neurovascular injury was observed. In comparisons between the perforated screw group and the non-perforated screw group, low height, low weight, low BMI, female sex, fellow surgeon, and narrow pedicle were considered as risk factors for CPS perforation using TGS.

conclusionCPS placement using the TGS showed very high clinical accuracy. Body size, sex, surgeon's experience, and pedicle width may affect the accuracy of CPS placement using TGS.

Indexed as

Cervical VertebraePedicle ScrewsSpinal FusionSurgery, Computer-AssistedAdultAgedAged, 80 and overFemaleHumansMaleMiddle AgedRetrospective StudiesRisk FactorsTomography, X-Ray ComputedYoung AdultAccuracy of cervical pedicle insertionCervical pedicle screwsPatient-specific template-guided systemsRisk factor analysis of screw perforation

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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.