Difficult thoracic pedicle screw placement in adolescent idiopathic scoliosis

Basit Öğe Kaydı
dc.contributor.authorSenaran, Hakan
dc.contributor.authorShah, Suken A.
dc.contributor.authorGabos, Peter G.
dc.contributor.authorLittleton, Aaron G.
dc.contributor.authorNeiss, Geraldine
dc.contributor.authorGuille, James T.
dc.date.accessioned2020-03-26T17:26:40Z
dc.date.available2020-03-26T17:26:40Z
dc.date.issued2008
dc.departmentSelçuk Üniversitesien_US
dc.description.abstractStudy Design: Retrospective radiographic and clinical consecutive case series. Objective: The objective of this study was to identify patients treated with posterior spinal fusion and pedicle screw instrumentation for adolescent idiopathic scoliosis (AIS) in whom it was not possible to place a planned pedicle screw, and describe the possible difficulties in screw placement. Summary of Background Data: Despite the knowledge of anatomic characteristics of upper thoracic spine pedicles and considerable experience in thoracic pedicle screw placement, inserting pedicle screws in some patients with AIS may be difficult. Methods: We reviewed 96 patients with AIS in whom the intent was to use an all-screw construct in 2004. Placement of the pedicle screws was usually by the freehand method, with intraoperative fluoroscopy used as needed. If a screw could not be safely placed after multiple attempts, a down-going supralaminar or transverse process book was placed. Medical records were reviewed and radiographs were measured by one of the authors. Results: We identified 17 cases (18%) in which a hook had been placed. All cases had a major thoracic curve (Lenke 1, 2, and 3) and the single hook had always been placed at the most cephalad level of the construct on the patient's right side. The most common levels for hook placement were T3 and T4; these pedicles were noted to be sclerotic, narrow, and have a moderate amount of rotation on the preoperative posterior-anterior and side bending radiographs. Conclusions: Care should be exercised during pedicle screw instrumentation in the apical region of the proximal thoracic curve, whether structural or nonstructural, especially in the concavity. The preoperative radiographs may give helpful clues to intraoperative challenges of pedicle screw insertion at the uppermost level of instrumentation. Hook fixation was satisfactory in this scenario.en_US
dc.identifier.doi10.1097/BSD.0b013e318073cc1den_US
dc.identifier.endpage191en_US
dc.identifier.issn1536-0652en_US
dc.identifier.issn1539-2465en_US
dc.identifier.issue3en_US
dc.identifier.pmid18458588en_US
dc.identifier.scopusqualityN/Aen_US
dc.identifier.startpage187en_US
dc.identifier.urihttps://dx.doi.org/10.1097/BSD.0b013e318073cc1d
dc.identifier.urihttps://hdl.handle.net/20.500.12395/22325
dc.identifier.volume21en_US
dc.identifier.wosWOS:000255801000006en_US
dc.identifier.wosqualityQ3en_US
dc.indekslendigikaynakWeb of Scienceen_US
dc.indekslendigikaynakScopusen_US
dc.indekslendigikaynakPubMeden_US
dc.language.isoenen_US
dc.publisherLIPPINCOTT WILLIAMS & WILKINSen_US
dc.relation.ispartofJOURNAL OF SPINAL DISORDERS & TECHNIQUESen_US
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanıen_US
dc.rightsinfo:eu-repo/semantics/closedAccessen_US
dc.selcuk20240510_oaigen_US
dc.subjectadolescent idiopathic scoliosisen_US
dc.subjectthoracic pedicle screwsen_US
dc.subjectposterior spinal instrumentationen_US
dc.titleDifficult thoracic pedicle screw placement in adolescent idiopathic scoliosisen_US
dc.typeArticleen_US

Dosyalar

Koleksiyon

WoS İndeksli Yayınlar Koleksiyonu
PubMed İndeksli Yayın Koleksiyonu
Scopus İndeksli Yayınlar Koleksiyonu