[The assessment of accuracy and safety of thoracic pedicle screw placement in the fracture of thoracic spine].
OBJECTIVE
To investigate the accuracy and safety of pedicle screw placement in the fracture of thoracic spine.


METHODS
On the basis of imaging for the fracture of thoracic spine of 50 cases, the screw prick point, angle, depth and diameter were measured and defined on the thoracic vertebrae pedicle by CT thin-slice scan in standard prone in all cases. The accuracy and safety of screws placement was evaluated with X-ray and CT thin-slice scan in all cases postoperative.


RESULTS
Among of 240 thoracic pedicle screws that were inserted in 50 cases, 220 screws (91.7%) were fully contained within the cortical boundaries of the pedicle, 20 screws (8.3%) were misplaced, 7 screws (2.9%) laterally, 5 screws (2.1%) anterolateral and 2 (0.8%) of it demonstrated aortic abutment, 3 screws (1.3%) caudad perforations of the pedicle, 3 screws (1.3%) expended the wall of the pedicle to inside, 2 screws (0.8%) were misplaced in vertebral canal according to X ray and CT thin-slice scan. When comparing screws in different part of thoracic, there was a significant difference.


CONCLUSIONS
Preoperative CT measurement of the thoracic pedicle in the treatment of thoracic fracture can provide important data. It is important factors for thoracic pedicle screws that can be placed safety with guided by intraoperative fluoroscopic imaging and anatomic landmarks. CT thin-slice scan can evaluate accuracy misplace of thoracic pedicle screws, and show anatomic place surroundings of thoracic pedicle screws postoperative. More misplaced screws are seen proximally.
Hu
Yong
Y
Department of Spinal Surgery, the Sixth Hospital of Ning Bo, Zhejiang 315040, China. huyong610@163.com
Xu
Rong-ming
RM
Xie
Hui
H
Jia
Lian-shun
LS
Ruan
Yong-ping
YP
Ma
Wei-hu
WH
D000328:Adult; D001863:Bone Screws; D005260:Female; D005593:Fracture Fixation, Internal / Q000295:instrumentation / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015203:Reproducibility of Results; D012189:Retrospective Studies; D016103:Spinal Fractures / Q000601:surgery*; D013904:Thoracic Vertebrae / Q000293:injuries*; D016896:Treatment Outcome