Anterior transpedicular screw fixation of cervical spine: Is it safe? Morphological feasibility, technical properties, and accuracy of manual insertion

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dc.contributor.authorKoktekir, Ender
dc.contributor.authorToktas, Zafer Orkun
dc.contributor.authorSeker, Askin
dc.contributor.authorAkakin, Akin
dc.contributor.authorKonya, Deniz
dc.contributor.authorKilic, Turker
dc.date.accessioned2020-03-26T19:00:50Z
dc.date.available2020-03-26T19:00:50Z
dc.date.issued2015
dc.departmentSelçuk Üniversitesien_US
dc.description.abstractOBJECT Due to lack of construct stability of the current anterior cervical approaches, supplemental posterior cervical approaches are frequently employed. The use of an anterior-only approach with anterior transpedicular screws (ATPSs) has been proposed as a means of providing 3-column fixation. This study was designed to investigate the feasibility of anterior transpedicular screw (ATPS) fixation of cervical spine, to obtain the morphological measurements for technical prerequisites, and to evaluate the accuracy of the ATPS using fluoroscopy. METHODS The study included both radiological and anatomical investigations. The radiological investigations were based on data from cervical spine CT scans performed in 65 patients. Technical prerequisites of ATPS were calculated using OsiriX for Mac OS. In the anatomical part of the study, 30 pedicles (C3-7) from 6 formalin-preserved cadavers were manually instrumented. Measurements obtained included pedicle width (PW), pedicle height (PH), pedicle transverse angle (PTA), distance of the entry point from the midline (DEPM), and distance of the entry point from the superior endplate (DEPSEP). The authors also analyzed screw position in the manually instrumented vertebrae. RESULTS The mean PW and PH values showed a tendency to increase from C-3 to C-7 in both males and females. The means were significantly larger for both PW and PH in males than in females at all levels (p = 0.001). The overall mean PTA value was significantly lower at C-7 (p < 0.0001). The mean value for the distance of entry point from the midline (DEPM) represented a point at the contralateral side of the pedicle for every level except C-7. The mean DEPSEP values showed significant differences between all levels (p < 0.0001). Seven of the 30 screws were identified as breaching the pedicle (23.3%); these screw malplacements were seen at C-3 (3 screws), C-4 (2 screws), and C-5 (2 screws). CONCLUSIONS The morphological measurements of this study demonstrated that ATPS fixation is feasible in selected cases. They indicate that ATPS insertion using a fluoroscopy-assisted pedicle axis view is safe at the C-6 and C-7 levels, but the results at the other levels did not prove the safety of this technique.en_US
dc.identifier.doi10.3171/2014.10.SPINE14669en_US
dc.identifier.endpage604en_US
dc.identifier.issn1547-5654en_US
dc.identifier.issn1547-5646en_US
dc.identifier.issue6en_US
dc.identifier.pmid25815805en_US
dc.identifier.scopusqualityQ1en_US
dc.identifier.startpage596en_US
dc.identifier.urihttps://dx.doi.org/10.3171/2014.10.SPINE14669
dc.identifier.urihttps://hdl.handle.net/20.500.12395/31843
dc.identifier.volume22en_US
dc.identifier.wosWOS:000355031700007en_US
dc.identifier.wosqualityQ2en_US
dc.indekslendigikaynakWeb of Scienceen_US
dc.indekslendigikaynakScopusen_US
dc.indekslendigikaynakPubMeden_US
dc.language.isoenen_US
dc.publisherAMER ASSOC NEUROLOGICAL SURGEONSen_US
dc.relation.ispartofJOURNAL OF NEUROSURGERY-SPINEen_US
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanıen_US
dc.rightsinfo:eu-repo/semantics/openAccessen_US
dc.selcuk20240510_oaigen_US
dc.subjectanterior transpedicular screw fixationen_US
dc.subjectfluoroscopyen_US
dc.subjectaccuracyen_US
dc.subjectcervicalen_US
dc.subjectpedicleen_US
dc.subjectanatomyen_US
dc.titleAnterior transpedicular screw fixation of cervical spine: Is it safe? Morphological feasibility, technical properties, and accuracy of manual insertionen_US
dc.typeArticleen_US

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