The Use of Pedicle Screw-rod System for the Posterior Fixation in Cervico-thoracic Junction

Overview

Journal J Korean Neurosurg Soc

Date 2010 Aug 19

PMID 20717511

Citations 4

Authors

Wonik Cho

Ahmed Shawky Eid

Ung-Kyu Chang

Affiliations

Soon will be listed here.

Abstract

Objective: In cervico-thoracic junction (CTJ), the use of strong fixation device such as pedicle screw-rod system is often required. Purpose of this study is to analyze the anatomical features of C7 and T1 pedicles related to screw insertion and to evaluate the safety of pedicle screw insertion at these levels.

Methods: Nineteen patients underwent posterior CTJ fixation with C7 and/or T1 included in fixation levels. Seventeen patients had tumorous conditions and two with post-laminectomy kyphosis. The anatomical features were analyzed for C7 and T1 pedicles in 19 patients using computerized tomography (CT). Pedicle screw and rod fixation system was used in 16 patients. Pedicle violation by screws was evaluated with postoperative CT scan.

Results: The mean values of the width, height, stable depth, safety angle, transverse angle, and sagittal angle of C7 pedicles were 6.9 +/- 1.34 mm, 8.23 +/- 1.18 mm, 30.93 +/- 4.65 mm, 26.42 +/- 7.91 degrees, 25.9 +/- 4.83 degrees, and 10.6 +/- 3.39 degrees. At T1 pedicles, anatomic parameters were similar to those of C7. The pedicle violation revealed that 64.1% showed grade I violation and 35.9% showed grade II violation, overall. As for C7 pedicle screw insertion, grade I was 61.5% and grade II 38.5%. At T1 level, grade I was 65.0% and grade II 35.0%. There was no significant difference in violation rate between the whole group, C7, and T1 group.

Conclusion: C7 pedicles can withstand pedicle screw insertion. C7 pedicle and T1 pedicle are anatomically very similar. With the use of adequate fluoroscopic oblique view, pedicle screw can be safely inserted at C7 and T1 levels.

Citing Articles

Pedicle morphometry of the C7 and T1 vertebrae in an argentine population.

Devoto P, Minghinelli F, Mezzadri J, Pipolo D, Lacsi M, Jalon P Surg Neurol Int. 2024; 15:295.

PMID: 39246794 PMC: 11380883. DOI: 10.25259/SNI_356_2024.

Easy method to simplify "freehand" subaxial cervical pedicle screw insertion.

Burcev A, Pavlova O, Diachkov K, Diachkova G, Ryabykh S, Gubin A J Craniovertebr Junction Spine. 2018; 8(4):390-395.

PMID: 29403258 PMC: 5763603. DOI: 10.4103/jcvjs.JCVJS_92_17.

C7 intra-laminar screws for complex cervicothoracic spine surgery-a case series.

Wilson P, Selby M J Spine Surg. 2018; 3(4):561-566.

PMID: 29354732 PMC: 5760425. DOI: 10.21037/jss.2017.10.05.

Which salvage fixation technique is best for the failed initial screw fixation at the cervicothoracic junction? A biomechanical comparison study.

Hong J, Tomoyuki T, Jain A, Espinoza Orias A, Inoue N, An H Eur Spine J. 2017; 26(9):2417-2424.

PMID: 28752245 DOI: 10.1007/s00586-017-5239-8.

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