An extrapedicular approach to the placement of screws in the thoracic spine: An anatomic and radiographic assessment

A radiographic and anatomic study of an extrapedicular method of screw placement in cadaveric thoracic spines. To evaluate an alternative method of thoracic vertebral body screw fixation using an extrapedicular screw technique. To evaluate the anatomic safe zones and proper starting point for this a...

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Veröffentlicht in:Spine (Philadelphia, Pa. 1976) Pa. 1976), 2003-10, Vol.28 (20), p.2324-2330
Hauptverfasser: HUSTED, Daniel S, YUE, James J, FAIRCHILD, Todd A, HAIMS, Andrew H
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container_end_page 2330
container_issue 20
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container_title Spine (Philadelphia, Pa. 1976)
container_volume 28
creator HUSTED, Daniel S
YUE, James J
FAIRCHILD, Todd A
HAIMS, Andrew H
description A radiographic and anatomic study of an extrapedicular method of screw placement in cadaveric thoracic spines. To evaluate an alternative method of thoracic vertebral body screw fixation using an extrapedicular screw technique. To evaluate the anatomic safe zones and proper starting point for this alternative approach to the placement of screw fixation in the thoracic spine. Despite the clinical successes reported with thoracic pedicle screw-rod constructs, controversy exists about the safety of this technique in pedicles that are anatomically too small for transpedicular fixation. An alternative method of extrapedicular screw fixation was evaluated in this present study. Two fresh, unfixed, adult cadavers were obtained randomly; 6.0-mm AO Synthes pedicle screws were placed using an extrapedicular approach bilaterally from T3 to T10. The screws were placed according to one defined method described later. Computerized tomographic (CT) images were obtained. The position of each screw was analyzed. The cadavers were then dissected with the screw pathway exposed and the relation of the screw to surrounding anatomy documented. All screws did not penetrate the spinal canal. All screws were within the pedicle rib unit and did not penetrate the neural foramen or pleura. This study, although only introductory, indicates the potential for extrapedicular vertebral body fixation in the thoracic spine. Biomechanical evaluations are presently being conducted to evaluate the use of extrapedicular thoracic screw fixation.
doi_str_mv 10.1097/01.BRS.0000085361.32600.63
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To evaluate an alternative method of thoracic vertebral body screw fixation using an extrapedicular screw technique. To evaluate the anatomic safe zones and proper starting point for this alternative approach to the placement of screw fixation in the thoracic spine. Despite the clinical successes reported with thoracic pedicle screw-rod constructs, controversy exists about the safety of this technique in pedicles that are anatomically too small for transpedicular fixation. An alternative method of extrapedicular screw fixation was evaluated in this present study. Two fresh, unfixed, adult cadavers were obtained randomly; 6.0-mm AO Synthes pedicle screws were placed using an extrapedicular approach bilaterally from T3 to T10. The screws were placed according to one defined method described later. Computerized tomographic (CT) images were obtained. The position of each screw was analyzed. 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Graft diseases</subject><subject>Thoracic Vertebrae - anatomy &amp; histology</subject><subject>Thoracic Vertebrae - diagnostic imaging</subject><subject>Thoracic Vertebrae - surgery</subject><subject>Tomography, X-Ray Computed</subject><issn>0362-2436</issn><issn>1528-1159</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2003</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpFkF1rFDEUhkNR7Lb6F0oQ9G6mOZNJZqZ3tdgPKAhWr8OZ5MQdmS-TLNp_b7Zd2NwETp73TfIw9hFECaJrLgWUX74_lWK_WiU1lLLSQpRanrANqKotAFT3hm2E1FVR1VKfsrMYf2dcS-jesVOoVQ407Yal65nTvxRwJTfY3YiB47qGBe2Wp4WnLfF1REsTzYkvnkcb6G_kw_xylLZLQDtYHtdhpiuey3DGtEx5hLPjAd2w_Mrl2_0gRopxX_SevfU4Rvpw2M_Zz9uvP27ui8dvdw8314-FlU2dCq9Ik-tJWgcKfO-wa13TQuedA-8qS76itlVUN65XIFSLssdONVK7HgTIc_b5tTd_6M-OYjLTEC2NI8607KJpoGpqoboMXr2CNiwxBvJmDcOE4dmAMHvnRoDJzs3RuXlxbrTM4YvDLbt-IneMHiRn4NMBwGhx9AFnO8Qjp6r8jsz9B9wVjOc</recordid><startdate>20031015</startdate><enddate>20031015</enddate><creator>HUSTED, Daniel S</creator><creator>YUE, James J</creator><creator>FAIRCHILD, Todd A</creator><creator>HAIMS, Andrew H</creator><general>Lippincott</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20031015</creationdate><title>An extrapedicular approach to the placement of screws in the thoracic spine: An anatomic and radiographic assessment</title><author>HUSTED, Daniel S ; YUE, James J ; FAIRCHILD, Todd A ; HAIMS, Andrew H</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c374t-f5e6edbe3cd151fbda98d7819fdd1fd2cef2e885e47db51058a3ba95736db1013</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2003</creationdate><topic>Adult</topic><topic>Biological and medical sciences</topic><topic>Bone Screws</topic><topic>Cadaver</topic><topic>Humans</topic><topic>Internal Fixators</topic><topic>Medical sciences</topic><topic>Orthopedic Procedures - instrumentation</topic><topic>Orthopedic Procedures - methods</topic><topic>Orthopedic surgery</topic><topic>Surgery (general aspects). 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source MEDLINE; Journals@Ovid Complete
subjects Adult
Biological and medical sciences
Bone Screws
Cadaver
Humans
Internal Fixators
Medical sciences
Orthopedic Procedures - instrumentation
Orthopedic Procedures - methods
Orthopedic surgery
Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases
Thoracic Vertebrae - anatomy & histology
Thoracic Vertebrae - diagnostic imaging
Thoracic Vertebrae - surgery
Tomography, X-Ray Computed
title An extrapedicular approach to the placement of screws in the thoracic spine: An anatomic and radiographic assessment
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