Accuracy and safety of thoracic pedicle screw placement in spinal deformities.
OBJECTIVE
To determine the safety of pedicle screw fixation in thoracic spine deformity correction.


METHODS
One hundred twelve pedicle screws were surgically placed in 25 patients with degenerative, posttraumatic, and Scheuermann kyphosis and idiopathic and neuromuscular scoliosis. Screw position was evaluated using intraoperative and postoperative radiographs and thin-slice computed tomography.


RESULTS
Of the total 112 thoracic pedicle screws that were inserted, 98 screws (87.5%) were fully contained within the cortical boundaries of the pedicle. When comparing proximal screws (T1-T8) with distal screws (T9-T12) and convex placed screws with concave ones, a statistically significant difference in screw placement was evident (P < 0.05). More misplaced screws were seen proximally and on the concave side. Of the 14 malpositioned screws, 2 (1.8%) demonstrated aortic abutment. There were no neurologic deficits, vascular injuries, or mechanical failures recorded.


CONCLUSIONS
Placement of thoracic pedicle screws is both feasible and safe.
Smorgick
Yossi
Y
Spine Unit, Department of Orthopedic Surgery, Assaf Harofeh Medical Center, Zerifin, Israel. Noam_Yossi@hotmail.co.il
Millgram
Michael A
MA
Anekstein
Yoram
Y
Floman
Yizhar
Y
Mirovsky
Yigal
Y
D000293:Adolescent; D000328:Adult; D001863:Bone Screws / Q000706:statistics & numerical data*; D002648:Child; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007557:Israel / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology; D011379:Prognosis; D019919:Prosthesis Implantation / Q000706:statistics & numerical data*; D013121:Spinal Curvatures / Q000453:epidemiology* / Q000601:surgery*; D013123:Spinal Fusion / Q000295:instrumentation* / Q000706:statistics & numerical data*; D013904:Thoracic Vertebrae / Q000601:surgery*; D016896:Treatment Outcome