ENDOSCOPICALLY CHECKED TRANSPEDICULAR SCREW INSERTION
Journal Title: Journal of Turkish Spinal Surgery - Year 2005, Vol 16, Issue 3
Abstract
INTRODUCTION: Transpedicular screws are one of the most important components of the posterior segmental fixation systems. The most feared complication of transpedicular screw insertion is the possibility of neural damage due to contact during insertion process or continuous irritation of the malpositioned screw on the neural structures. There are many reports in the literature about complications related directly to malpositioning of the transpedicular screws. Currently the position of the screws is checked by palpatian of the pedicle walls by the help of a guide wire and fluoroscopic control. Our objective was to inspect the screw hole endoscopically would prevent malpositioning of the transpedicular screws and decrease complications related to them. MATERIALS AND METHODS: Between 2003 and 2004, 20 consecutive patients who underwent segmental spinal fixation by transpedicular screws lar a variety of reasons were included. A total of 76 screw holes were endoscopically examined prior to insertion of the screws. RESULTS: In three screws anterior penetration of the holethrough the corpuscular wall was detected and a shorter screw was inserted. Lateral penetration of the vertebra was observed in one case and screw hale was rerouted. In another case osteopenic bone was visualized and the pedicle was grafted before insertion of the screw. CONCLUSIONS: Complications due to malpositioned screws can be prevented by endoscopic visualization of the screw hole. Direct visualization of the hole aids in prevention of complications related to insertion of the screw through defective area. We believe, although it adds to the total operative time, avoiding the unpredictable complications worth the time spent. Fig-1 Endoscopical view of intact bony lamellae. Fig-2 Endoscopical view ol anterior penetration of corpuscular wall.
Authors and Affiliations
TARIK YAZAR (Ankara University, Turkey), KEREM BAÞARIR
Keywords
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