title: Pedicle screw insertion techniques: an update and review of the literature.
abstract: Pedicle screw construct have become one of the most practiced procedure in spinal surgery. Despite commonly used, questions remain about their safety especially for the thoracic spine and in deformity where difficulty in positioning can lead to pedicle breach and adjacent structures injury. Misplacement rates have been reported to be from 5 to 41% in the lumbar spine and from 3 to 55% in the thoracic spine. Hence, various procedures have been described in order to improve pedicle screw insertion accuracy. Aim of this study is to evaluate current concepts on pedicle screws placement techniques to better understand recent attitude and clarify some doubts when selecting the most proper method.
authors.affiliation: Istituto Ortopedico Rizzoli, Bologna, Italy. pernafa@gmail.com.
authors.forename: F
authors.identifier: http://orcid.org/0000-0002-8618-8192
authors.initials: F
authors.lastname: Perna
authors.affiliation: Istituto Ortopedico Rizzoli, Bologna, Italy.
authors.forename: R
authors.initials: R
authors.lastname: Borghi
authors.affiliation: Istituto Ortopedico Rizzoli, Bologna, Italy.
authors.forename: F
authors.initials: F
authors.lastname: Pilla
authors.affiliation: Istituto Ortopedico Rizzoli, Bologna, Italy.
authors.forename: N
authors.initials: N
authors.lastname: Stefanini
authors.affiliation: Istituto Ortopedico Rizzoli, Bologna, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Mazzotti
authors.affiliation: Istituto Ortopedico Rizzoli, Bologna, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Chehrassan
mesh_terms: D005471:Fluoroscopy / Q000379:methods; D006801:Humans; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging / Q000601:surgery*; D065289:Pedicle Screws; D012600:Scoliosis / Q000601:surgery*; D013123:Spinal Fusion / Q000379:methods; D013130:Spinal Stenosis; D025321:Surgery, Computer-Assisted / Q000379:methods; D013904:Thoracic Vertebrae / Q000000981:diagnostic imaging / Q000601:surgery*; D016896:Treatment Outcome
keywords: Computer-assisted surgery; Fluoroscopy; Freehand; Navigation; Scoliosis; Spinal stenosis; Spondylolisthesis; Vertebral entry points