A prospective study of 50 adults treated with fusion, realignment, and segmental spinal instrumentation for spinal deformity was conducted to assess the safety, accuracy, and efficacy of the free-hand pedicle screw placement technique. Postoperative computed tomographic scans were performed to evaluate the placement of 282 screws and were correlated with patients' clinical outcomes. Five screws were placed at T12, 26 at L1, 39 at L2, 48 at L3, 73 at L4, 35 at L5, and 50 at S1. Nine screws (3%) were misplaced and included three screws (1.06%) that violated the medial wall with no clinical sequelae or revision surgery needed. There were no neurologic deficits related to screw placement. The free-hand technique is a safe and cost-effective method for pedicular screw placement during surgery for adult spine deformities.
Scoliosis Service, Hospital for Special Surgery, Cornell University Medical School, New York, New York, U.S.A.
Received September 14, 1999; accepted April 25, 2000.
Address correspondence and reprint requests to Dr. O. Boachie-Adjei, Hospital for Special Surgery, 535 East 70th Street, New York, NY 10021, U.S.A. E-mail: Boachie@hss.edu
Supported by a DePuy AcroMed (Raynham, MA, U.S.A.) educational grant.
