Mid-length Pedicle Screws in Posterior Instrumentation of Scoliosis

Autor: Tevfik Balıkçı, Görkem Kiyak, Motasim Khalid Bawaneh, Ahmed Majid Heydar, Murat Bezer
Rok vydání: 2019
Předmět:
Zdroj: Asian Spine Journal, Vol 13, Iss 5, Pp 815-822 (2019)
Asian Spine Journal
ISSN: 1976-7846
1976-1902
DOI: 10.31616/asj.2018.0177
Popis: Study Design Prospective analysis of collected data. Purpose We determine the need for the use of mid-length pedicle screws (screws with 2.5-mm long increments) during posterior spinal instrumentation. Overview of Literature Many biomechanical studies have been performed showing that increasing the pedicle screw insertion depth provides an improved resistance to pullout, cyclic loading, and derotational forces, but no intermediate length screws were used. Methods We prospectively evaluated 120 patients who received posterior segmental instrumentation for structural scoliosis. Preoperatively, 91.44-cm long cassette anteroposterior (AP), lateral, and AP bending radiographs and multiplanar computed tomography were performed in all patients routinely. We measured chord length to determine the maximum probable screw length of all vertebrae. All pedicle screws were attempted to be placed as long as possible. The main intention was at least to engage the subcortical bone of the anterior vertebral cortex. Especially in the apical region, the screws were attempted to be inserted bicortically. The length, level, region, and side of each screw were recorded. Screws with 5-mm increments were called standard length screws (SLS), and middle-sized screws with 2.5-mm increments were called mid-length screws (MLS). Results Of 2,846 pedicle screws inserted, 1,575 (55.4%) were SLS and 1,271 (44.6%) were MLS, demonstrating a need for MLS in scoliosis surgery (p
Databáze: OpenAIRE
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