open access

Vol 50, No 5 (2016)
Original research articles
Submitted: 2016-05-08
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Feasibility and accuracy of new insertion technique of S1 transpedicular screw. Computed tomography-based morphometric analysis

Łukasz Kubaszewski, Grzegorz Miękisiak, Andrzej Nowakowski, Celina Pezowicz, Grzegorz Bajor, Zdzisław Kiełbowicz, Wojciech Kinda, Magdalena Wojtków, Jacek Kaczmarczyk
DOI: 10.1016/j.pjnns.2016.06.005
·
Neurol Neurochir Pol 2016;50(5):363-369.

open access

Vol 50, No 5 (2016)
Original research articles
Submitted: 2016-05-08

Abstract

Objective

To assess feasibility and accuracy of a new insertion technique of S1 transpedicular screw.

Summary of background data

Transpedicular stabilization in the first sacral vertebra (S1) is a technically demanding surgical procedure with inherent risk of loosening of the implant. A modification of the technique was recently proposed, along with the analytical verification which was performed based on the available literature. In the study, we performed radiological assessment of screws inserted into the S1 using the classical and modified techniques.

Methods

The analysis was performed in two parts. The first part was performed on eight cadaver specimens after implantation of the screws. In the second part, we used computed tomography images of patients with degenerative disk disease with a superimposed representation of screws. The thickness of the posterior cortex adherent to the screws, screw trajectory and their position with regard to the spinal canal was measured. The area of posterior cortex in contact with the screws was also calculated.

Results

The contact length and area was found to be two times greater for screws introduced with the modified technique. The convergence angle was comparable between the techniques, despite the shift of entry point. There was no canal breach, although with the modified technique the screws passed closer to the spinal canal.

Conclusions

The modified technique is considered safe. In this technique, the screws pass through a thicker portion of the posterior cortex compared to the classical technique that aims at improving the stability of the fixation.

Abstract

Objective

To assess feasibility and accuracy of a new insertion technique of S1 transpedicular screw.

Summary of background data

Transpedicular stabilization in the first sacral vertebra (S1) is a technically demanding surgical procedure with inherent risk of loosening of the implant. A modification of the technique was recently proposed, along with the analytical verification which was performed based on the available literature. In the study, we performed radiological assessment of screws inserted into the S1 using the classical and modified techniques.

Methods

The analysis was performed in two parts. The first part was performed on eight cadaver specimens after implantation of the screws. In the second part, we used computed tomography images of patients with degenerative disk disease with a superimposed representation of screws. The thickness of the posterior cortex adherent to the screws, screw trajectory and their position with regard to the spinal canal was measured. The area of posterior cortex in contact with the screws was also calculated.

Results

The contact length and area was found to be two times greater for screws introduced with the modified technique. The convergence angle was comparable between the techniques, despite the shift of entry point. There was no canal breach, although with the modified technique the screws passed closer to the spinal canal.

Conclusions

The modified technique is considered safe. In this technique, the screws pass through a thicker portion of the posterior cortex compared to the classical technique that aims at improving the stability of the fixation.

Get Citation

Keywords

Anatomy, Pedicle screw, Sacrum, Entry point

About this article
Title

Feasibility and accuracy of new insertion technique of S1 transpedicular screw. Computed tomography-based morphometric analysis

Journal

Neurologia i Neurochirurgia Polska

Issue

Vol 50, No 5 (2016)

Pages

363-369

DOI

10.1016/j.pjnns.2016.06.005

Bibliographic record

Neurol Neurochir Pol 2016;50(5):363-369.

Keywords

Anatomy
Pedicle screw
Sacrum
Entry point

Authors

Łukasz Kubaszewski
Grzegorz Miękisiak
Andrzej Nowakowski
Celina Pezowicz
Grzegorz Bajor
Zdzisław Kiełbowicz
Wojciech Kinda
Magdalena Wojtków
Jacek Kaczmarczyk

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