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Computed tomographic evaluation of thoracic pedicle screw placement in idiopathic scoliosis

Rodrigues, Luciano M.R.; Nicolau, Rodrigo J.; Milani, Carlo

Journal of Pediatric Orthopaedics B:
doi: 10.1097/BPB.0b013e328344105c
Spine and Pelvis
Abstract

This retrospective observational study aimed to determine the accuracy of the placement of transpedicular thoracic screws used in idiopathic scoliosis and to evaluate the position and safety of the implants using postoperative computed tomography. Twenty-nine patients who underwent surgery for scoliosis between May 2003 and November 2005 were included in this study. The mean spinal curvature was 67°, and all of the patients had thoracic screws or hooks implanted. The positioning of 78 pedicle screws was evaluated using computed tomography after the free-handed technique was performed. The mean spinal curvature after surgery was 29°. Seventy-six percent of the screws were fully contained within the pedicle. Twenty-one screws breached the pedicle by between 2 and 4 mm (three medially and 18 laterally). Two screws were broken. A neurological deficit was identified in one case after surgery, but the deficit was reversed after the removal of the screws. This screw had a medial breach of greater than 4 mm. Most screws were inserted between the cortical vertebrae. Misplaced screws were most commonly inserted with a lateral cortical perforation.

Author Information

Faculdade de Medicina do ABC, Discipline of Orthopaedics, Carlo Milani, São Paulo, Brazil

Correspondence to Professor Carlo Milani, PhD, Faculdade de Medicina do ABC, Discipline of Orthopaedics, Carlo Milani, Rua Américo Brasiliense, 596, São Bernardo do Campo, São Paulo, CEP 09715-021, Brazil Tel: +55 11 4083 6852; fax: + 55 11 4083 6835; e-mail: carlom@uol.com.br

© 2011 Lippincott Williams & Wilkins, Inc.