TRANSPEDICULAR SCREW FIXATION OF THE CERVICAL SPINE: LITERATURE REVIEW AND CLINICAL DATA
https://doi.org/10.14531/ss2017.3.47-53
Abstract
An analysis of key publications devoted to transpedicular fixation of the cervical spine has been carried out. The installation of transpedicular screws in the cervical spine is a technically challenging procedure, the frequency of screw deviation from the optimal trajectory remains high even with the use of modern intraoperative technologies, and there is a risk of serious lifethreatening complications. The use of this technique allows achieving reliable three-column stabilization of the cervical spine through only posterior approach, which is the preferred or only possible option for a limited group of patients. According to literature data, screw displacement beyond the pedicle borders occurs, on average, in 15–20 % of cases, while clinically significant complications occur in 4–5 % of cases. Among 32 operated patients, one severe neurologic complication caused by vertebral artery compression by the screw was noted. Of the 79 installed screws, 18 (22.79 %) cases of lateral pedicle wall perforation were observed. There were no cases of the fixator instability, infection and radiculopathy due to compression by the screw.
About the Authors
Alexandr Ya. Aleynik
Privolzhsky Federal Research Center
Russian Federation
MD, PhD, neurosurgeon, researcher in the spinal pathology group, Privolzhsky Federal Research Center, Nizhny Novgorod, Russia
Russian Federation
MD, PhD, neurosurgeon, researcher in the spinal pathology group, Privolzhsky Federal Research Center, Nizhny Novgorod, Russia
Sergey G. Mlyavykh
Privolzhsky Federal Research Center
Russian Federation
MD, PhD, board-certified neurosurgeon, head of neurosurgical department, Privolzhsky Federal Research Center, Nizhny Novgorod, Russia
Russian Federation
MD, PhD, board-certified neurosurgeon, head of neurosurgical department, Privolzhsky Federal Research Center, Nizhny Novgorod, Russia
Andrey E. Bokov
Privolzhsky Federal Research Center
Russian Federation
MD, PhD, neurosurgeon, researcher in the spinal pathology group, Privolzhsky Federal Research Center, Nizhny Novgorod, Russia
Russian Federation
MD, PhD, neurosurgeon, researcher in the spinal pathology group, Privolzhsky Federal Research Center, Nizhny Novgorod, Russia
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Review
For citations:
Aleynik A.Ya., Mlyavykh S.G., Bokov A.E. TRANSPEDICULAR SCREW FIXATION OF THE CERVICAL SPINE: LITERATURE REVIEW AND CLINICAL DATA. Russian Journal of Spine Surgery (Khirurgiya Pozvonochnika). 2017;14(3):47-53. https://doi.org/10.14531/ss2017.3.47-53
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