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Clinical Article
Korean J Spine 2005;2(3): 232-236.
15
Cervical Spine Reconstruction Using Pedicle Screw Fixation
Chul-Jae Lee, M.D., Byung-Chan Jeon, M.D., Tae-Sang Chun, M.D., Nam-Kyu Kim, M.D., Yong-Sook Park, M.D.
Department of Neurosurgery, Kosin University College of Medicine, Busan, Korea
Cervical Spine Reconstruction Using Pedicle Screw Fixation
Chul-Jae Lee, M.D., Byung-Chan Jeon, M.D., Tae-Sang Chun, M.D., Nam-Kyu Kim, M.D., Yong-Sook Park, M.D.
Abstract
Objective: Although the cervical pedicle screw fixation is considered the most effective instrumentation for posterior cervical spine surgery, reports on clinical application are limited due to possible risk of neurovascular injuries. The purpose of this study is to evaluate the accuracy of placement of the cervical pedicle screw.
Methods: Between August 2003 and December 2004, twelve patients were investigated. Cervical and cervicothoracic disorders included two column or three columnar injury by trauma in 6 patients, metastatic spine tumor in 3 and 3 had spondy- lotic myelopathy with instability. In these cases, screw placement, fusion rate and complications were assessed retrospectively.
Results: The male/female ratio was 8 : 4. The average age was 39 years. Average operative time was 179 minutes(range 110節ž320 minutes). The mean follow-up period was 13.8 months(range 6節ž23month). Sixty four pedicle screws were placed in 12 patients. Two screws(3%) were completely perforated, five(7.8%) were partially perforated and others(89.2%) were well positioned in the pedicle. All patients except for those with metastatic lesions, solid fusion was obtained. Proper position of screw was confirmed with a computed tomography scan slice thickness of 3mm. There were no neurovascular complications.
Conclusions: The cervical pedicle screw fixation procedure is very useful in patients with one-stage posterior decompression and stabilization. Furthermore, the rigid fixation using this procedure provides a high fusion rate. However, the risk of neuro- vascular injuries, however, cannot be completely eliminated. Meticulous preoperative computerized tomography(CT) assessment of each pedicle and maintenance of an intended angle of screw especially in transverse plane are essential for this procedure.
Keywords: Cervical spine reconstruction.Pedicle screw
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