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- Title
Minimally invasive cortical bone trajectory screws placement via pedicle or pedicle rib unit in the lower thoracic spine: a cadaveric and radiographic study.
- Authors
Xuan, Jun; Zhang, Di; Jin, Hai-Ming; Chen, Jiao-Xiang; Xu, Dao-Liang; Xu, Hong-Ming; Wu, Yao-Sen; Wang, Xiang-Yang
- Abstract
<bold>Purpose: </bold>To evaluate the feasibility of cortical bone trajectory (CBT) screws fixation via pedicle or pedicle rib unit in the cadaveric thoracic spine (T9-T12).<bold>Methods: </bold>Computed tomography (CT) images of 100 patients are analyzed by multiplanar reconstruction. Ten cadaveric thoracic spines are used to insert 4.5 × 35.0 mm CBT screws at all levels from T9 to T12.<bold>Results: </bold>Maximal screw length obtained by CT has a tendency to gradually increase from T9 (29.64 mm) to T12 (32.84 mm), and the difference reaches significant level at all levels except T9 versus T10 (P < 0.01). Maximal screw diameter increases from T9 (4.92 mm) to T12 (7.47 mm) and the difference reaches significant level among all levels (P < 0.01). Lateral angle increases from T9 (7.37°) to T12 (10.47°), and the difference reaches significant level among all levels except T11 versus T12. Cephalad angle from T9 to T12 are 19.03°, 22.10°, 25.62° and 27.50° (P < 0.01), respectively. The percentage of the inner and outer pedicle breakage are 2.5 and 22.5 %, respectively. The violation of lateral pedicle wall occurs at T9 and T10, especially for women at T9.<bold>Conclusions: </bold>Both radiographic and cadaveric studies establish the feasibility of CBT screws placement via pedicle or pedicle rib unit in the lower thoracic spine (T9-T12). Furthermore, our measurements are also useful for application of this technique.
- Subjects
COMPACT bone; PEDICLE flaps (Surgery); COMPUTED tomography; THORACIC vertebrae; RIB surgery; DIAGNOSTIC imaging; SURGERY; BONE screws; DEAD; MINIMALLY invasive procedures; ORTHOPEDIC surgery; PILOT projects
- Publication
European Spine Journal, 2016, Vol 25, Issue 12, p4199
- ISSN
0940-6719
- Publication type
journal article
- DOI
10.1007/s00586-016-4730-y