Navigation-Guided Subaxial Cervical Pedicle Screws in Revision Spine Surgery: 2-Dimensional Operative Video. Issue 4 (29th December 2020)
- Record Type:
- Journal Article
- Title:
- Navigation-Guided Subaxial Cervical Pedicle Screws in Revision Spine Surgery: 2-Dimensional Operative Video. Issue 4 (29th December 2020)
- Main Title:
- Navigation-Guided Subaxial Cervical Pedicle Screws in Revision Spine Surgery: 2-Dimensional Operative Video
- Authors:
- Mao, Jennifer Z
Agyei, Justice O
Ghannam, Moleca M
Khan, Asham
Christensen, Marc
Meyers, Joshua E
Pollina, John
Mullin, Jeffrey P - Abstract:
- Abstract: Traditionally, lateral mass screws (LMSs) have been the mainstay of posterior fixation in the subaxial spine. Although LMSs provide adequate fixation, cervical pedicle screws (CPSs) facilitate high fusion rates (90.5%) and provide for greater bone purchase, better reduction, lower rates of screw loosening or pull out, 2 times greater biomechanical advantage, superior stabilization, decreased development of pseudarthrosis, and decreased revision surgeries compared to LMSs. 1-4 In addition, CPSs can be a powerful bail-out option after lateral mass construct failure. Navigation-guided CPS placement has been reported to have an accuracy of 90.3%. 5 Navigation has the added advantage of mitigating screw malposition for the placement of CPS because of the smaller pedicle sizes and variability in cervical anatomy. 1, 3, 6 The potential risks of subaxial CPS placement include the risks of vertebral artery injury, spinal cord injury, and injury to adjacent neurovasculature. 2 The overall radiographic breach rate with intraoperative imaging is reported to range from 2.9% of 22.9%, with the majority of breaches occurring in the lateral direction. 7, 8 Despite radiographic breaches, the occurrence of nerve root injury (0.31% per screw), vertebral artery injury (0.15% per screw), and spinal cord injury (0% per screw) is rare. 3, 7 Here, we demonstrate navigation-assisted C1-C2 posterior fusion, with combined C1 LMSs and C2 pedicle screws with subaxial pedicle screw revision ofAbstract: Traditionally, lateral mass screws (LMSs) have been the mainstay of posterior fixation in the subaxial spine. Although LMSs provide adequate fixation, cervical pedicle screws (CPSs) facilitate high fusion rates (90.5%) and provide for greater bone purchase, better reduction, lower rates of screw loosening or pull out, 2 times greater biomechanical advantage, superior stabilization, decreased development of pseudarthrosis, and decreased revision surgeries compared to LMSs. 1-4 In addition, CPSs can be a powerful bail-out option after lateral mass construct failure. Navigation-guided CPS placement has been reported to have an accuracy of 90.3%. 5 Navigation has the added advantage of mitigating screw malposition for the placement of CPS because of the smaller pedicle sizes and variability in cervical anatomy. 1, 3, 6 The potential risks of subaxial CPS placement include the risks of vertebral artery injury, spinal cord injury, and injury to adjacent neurovasculature. 2 The overall radiographic breach rate with intraoperative imaging is reported to range from 2.9% of 22.9%, with the majority of breaches occurring in the lateral direction. 7, 8 Despite radiographic breaches, the occurrence of nerve root injury (0.31% per screw), vertebral artery injury (0.15% per screw), and spinal cord injury (0% per screw) is rare. 3, 7 Here, we demonstrate navigation-assisted C1-C2 posterior fusion, with combined C1 LMSs and C2 pedicle screws with subaxial pedicle screw revision of prior failed instrumentation. 3 The patient gave informed consent for surgery and video recording. Institutional review board approval was deemed unnecessary. … (more)
- Is Part Of:
- Operative neurosurgery. Volume 20:Issue 4(2021)
- Journal:
- Operative neurosurgery
- Issue:
- Volume 20:Issue 4(2021)
- Issue Display:
- Volume 20, Issue 4 (2021)
- Year:
- 2021
- Volume:
- 20
- Issue:
- 4
- Issue Sort Value:
- 2021-0020-0004-0000
- Page Start:
- E312
- Page End:
- E313
- Publication Date:
- 2020-12-29
- Subjects:
- Atlantoaxial instability -- Cervical fusion -- Navigation -- Odontoid fracture -- Jefferson fracture -- Cervical instability
Nervous system -- Surgery -- Periodicals
617.480590 - Journal URLs:
- https://academic.oup.com/ons/issue ↗
http://journals.lww.com/onsonline/pages/default.aspx ↗
http://journals.lww.com/pages/default.aspx ↗ - DOI:
- 10.1093/ons/opaa412 ↗
- Languages:
- English
- ISSNs:
- 2332-4252
- Deposit Type:
- Legaldeposit
- View Content:
- Available online (eLD content is only available in our Reading Rooms) ↗
- Physical Locations:
- British Library DSC - 6269.380200
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