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KMID : 1099620170140030084
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Korean Journal of Spine
2017 Volume.14 No. 3 p.84 ~ p.88
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Cervical Pedicle Screw Placement Using Medial Funnel Technique
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Lee Jung-Hwan
Choi Byung-Kwan
Han In-Ho
Choi Won-Gyu
Nam Kyoung-Hyup
Kim Hwan-Soo
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Abstract
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Objective: Cervical pedicle screw (CPS) placement is very challenging due to high risk of neurovascular complications. We devised a new technique (medial funnel technique) to improve the accuracy and feasibility of CPS placement.
Methods: We reviewed 28 consecutive patients undergoing CPS instrumentation using the medial funnel technique. Their mean age was 51.4 years (range, 30?81 years). Preoperative diagnosis included degenerative disease (n=5), trauma (n=22), and infection (n=1). Screw perforations were graded with the following criteria: grade 0 having no perforation, grade 1 having <25%, grade 2 having 25%?50% and grade 3 having >50% of screw diameter. Grades 0 and 1 were considered as correct position. The degree of perforation was determined by 2 junior neurosurgeons and 1 senior neurosurgeon.
Results: A total of 88 CPSs were inserted. The rate of correct placement was 94.3%; grade 0, 54 screws; grade 1, 29 screws; grade 2, 4 screws; and grade 3, 1 screw. No neurovascular complications or failure of instrumentation occurred. In perforated screws (34 screws), lateral perforations were 4 and medial perforations were 30.
Conclusion: We performed CPS insertion using medial funnel technique and achieved 94.3% (83 of 88) of correct placement. And it can decrease lateral perforation.
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KEYWORD
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Cervical vertebrae, Pedicle screws, Bone screws
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