The accuracy and safety of fluoroscopically guided percutaneous pedicle screws in the lumbosacral junction and the lumbar spine: a review of 880 screws
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The accuracy and safety of fluoroscopically guided percutaneous pedicle screws in the lumbosacral junction and the lumbar spine: a review of 880 screws. / Chiu, C K; Kwan, M K; Chan, C Y W; Schäfer, Christian; Hansen-Algenstaedt, N.
in: BONE JOINT J, Jahrgang 97-B, Nr. 8, 08.2015, S. 1111-7.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
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TY - JOUR
T1 - The accuracy and safety of fluoroscopically guided percutaneous pedicle screws in the lumbosacral junction and the lumbar spine: a review of 880 screws
AU - Chiu, C K
AU - Kwan, M K
AU - Chan, C Y W
AU - Schäfer, Christian
AU - Hansen-Algenstaedt, N
N1 - ©2015 The British Editorial Society of Bone & Joint Surgery.
PY - 2015/8
Y1 - 2015/8
N2 - We undertook a retrospective study investigating the accuracy and safety of percutaneous pedicle screws placed under fluoroscopic guidance in the lumbosacral junction and lumbar spine. The CT scans of patients were chosen from two centres: European patients from University Medical Center Hamburg-Eppendorf, Germany, and Asian patients from the University of Malaya, Malaysia. Screw perforations were classified into grades 0, 1, 2 and 3. A total of 880 percutaneous pedicle screws from 203 patients were analysed: 614 screws from 144 European patients and 266 screws from 59 Asian patients. The mean age of the patients was 58.8 years (16 to 91) and there were 103 men and 100 women. The total rate of perforation was 9.9% (87 screws) with 7.4% grade 1, 2.0% grade 2 and 0.5% grade 3 perforations. The rate of perforation in Europeans was 10.4% and in Asians was 8.6%, with no significant difference between the two (p = 0.42). The rate of perforation was the highest in S1 (19.4%) followed by L5 (14.9%). The accuracy and safety of percutaneous pedicle screw placement are comparable to those cited in the literature for the open method of pedicle screw placement. Greater caution must be taken during the insertion of L5 and S1 percutaneous pedicle screws owing to their more angulated pedicles, the anatomical variations in their vertebral bodies and the morphology of the spinal canal at this location.
AB - We undertook a retrospective study investigating the accuracy and safety of percutaneous pedicle screws placed under fluoroscopic guidance in the lumbosacral junction and lumbar spine. The CT scans of patients were chosen from two centres: European patients from University Medical Center Hamburg-Eppendorf, Germany, and Asian patients from the University of Malaya, Malaysia. Screw perforations were classified into grades 0, 1, 2 and 3. A total of 880 percutaneous pedicle screws from 203 patients were analysed: 614 screws from 144 European patients and 266 screws from 59 Asian patients. The mean age of the patients was 58.8 years (16 to 91) and there were 103 men and 100 women. The total rate of perforation was 9.9% (87 screws) with 7.4% grade 1, 2.0% grade 2 and 0.5% grade 3 perforations. The rate of perforation in Europeans was 10.4% and in Asians was 8.6%, with no significant difference between the two (p = 0.42). The rate of perforation was the highest in S1 (19.4%) followed by L5 (14.9%). The accuracy and safety of percutaneous pedicle screw placement are comparable to those cited in the literature for the open method of pedicle screw placement. Greater caution must be taken during the insertion of L5 and S1 percutaneous pedicle screws owing to their more angulated pedicles, the anatomical variations in their vertebral bodies and the morphology of the spinal canal at this location.
KW - Adolescent
KW - Adult
KW - Aged
KW - Aged, 80 and over
KW - Female
KW - Fluoroscopy
KW - Germany
KW - Humans
KW - Lumbar Vertebrae
KW - Lumbosacral Region
KW - Malaysia
KW - Male
KW - Middle Aged
KW - Pedicle Screws
KW - Postoperative Complications
KW - Radiography, Interventional
KW - Retrospective Studies
KW - Spinal Diseases
KW - Tomography, X-Ray Computed
KW - Treatment Outcome
U2 - 10.1302/0301-620X.97B8.35330
DO - 10.1302/0301-620X.97B8.35330
M3 - SCORING: Journal article
C2 - 26224830
VL - 97-B
SP - 1111
EP - 1117
JO - BONE JOINT J
JF - BONE JOINT J
SN - 2049-4394
IS - 8
ER -