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Please use this identifier to cite or link to this item: http://hdl.handle.net/1807/7874

Title: Posterior thoracic segmental pedicle screw instrumentation: evolving methods of safe and effective placement
Authors: Zeiller, S. C.
Lee, J.
Lim, M.
Vaccaro, A. R.
Keywords: Computerized tomography; safety; spinal fixation; thoracic pedicle screw
Issue Date: 31-Dec-2005
Publisher: Medknow Publications on behalf of the Neurological Society of India
Citation: Neurology India (ISSN: 0028-3886) Vol 53 Num 4
Abstract: The use of pedicle screw instrumentation in the spine has evolved over the last two decades. The initial use of pedicle screws began in the lumbar spine. As surgeons have become more comfortable with the complex anatomy required for accurate screw placement, the use of pedicle instrumentation has evolved to include their use in the thoracolumbar and thoracic spine. The impetus behind their increased use is a result of the many advantages that pedicle screw anchorage offers over traditional hook and rod constructs. Improved deformity correction and overall construct rigidity are two important advantages of pedicle screw instrumentation due its three-column control over the spinal elements. First, pedicle screw instrumentation obviates the need to place instrumentation within the spinal canal with its inherent risk of neurologic injury. Second, the placement of pedicle screws is independent of facet or laminar integrity and thus has been extremely useful in traumatic, neoplastic, and degenerative conditions. The benefits of pedicle screws in the thoracic spine has been tempered by the potential for catastrophic neurological or soft tissue injuries due to the close proximity of these structures. The narrow and inconsistent shape of the thoracic pedicles, especially in spinal deformity, makes their placement technically challenging. As a result, surgeons have employed a number of techniques to ensure the safe and efficacious placement of thoracic pedicle screws. Detailed anatomic landmarks used to determine pedicle location, intraoperative imaging including navigation, and neurophysiological monitoring are some of the techniques currently used by surgeons. The implementation of these techniques and a thorough understanding of the complex three-dimensional anatomy have allowed surgeons to successfully place thoracic and thoracolumbar pedicle screws.
URI: http://hdl.handle.net/1807/7874
Other Identifiers: http://www.bioline.org.br/abstract?id=ni05151
Rights: Copyright 2005 Neurology India.
Appears in Collections:Bioline International Legacy Collection

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