Cervical Pedicle Screws.pdfVIP

SPINE Volume 30, Number 20, pp 2280–2287 ?2005, Lippincott Williams Wilkins, Inc. Cervical Pedicle Screws: Conventional Versus Computer-Assisted Placement of Cannulated Screws Marcus Richter, MD, PhD,* Balkan Cakir, MD,? and Rene′ Schmidt, MD? Study Design. Prospective clinical study with postop- and neural elements, the use of a CAS system seems erative radiologic control of pedicle screw placement in to be bene?cial, especially for pedicle instrumentation the cervical spine. C3–C6. Objectives. To evaluate whether cervical pedicle Key words: computer-assisted surgery, cervical spine, screws can be placed safely in a conventional technique posterior instrumentation, pedicle screws, in vivo. Spine when using cannulated screws and separate stab inci- 2005;30:2280–2287 sions. Also, to evaluate if accuracy and safety of pedicle screw placement can be improved using a computer- The use of pedicle screw-based spinal instrumentation assisted surgery CAS system VectorVision; BrainLAB AG, Heimstetten, Germany . systems in the lumbar and thoracic spine has increased Summary of Background Data. Pedicle screws are tremendously during the last decade because of their su- rarely used in the cervical spine compared to the use in perior biomechanical properties and reduction possibil- lumbar and thoracic spine. The main reason is probably ities.1 In the lumbar and thoracic spine, conventional the potential risk of iatrogenic damage to the spinal cord, screw insertion techniques have been associated with nerve roots, or vertebral artery caused by screw misplace- ment as well as the more demanding technique of pedicle higher screw misplacement rates in cadaver studies com- screw placement in the cervical spine. pared to instrumentation with the assistance of a com- Methods. A total of 52 consecutive patients with pos- puter-assisted surgery CAS system VectorVision; terior cervical or cervicothorac