الفهرس | Only 14 pages are availabe for public view |
Abstract Pedicle screw placement is a technically demanding procedure. Fortunately, most complications are not severe. When the patient shows a neurological deficit after surgery, CT scanning is indicated to document the location of the pedicle screws. The discrepancy between radiographs and CT was most striking with medial misplaced screw, where CT depicted 10 times as many definite or questionable violations of the pedicle cortex than did conventional radiographs. Assistive techniques were designed to decrease the breach rate and improve pedicle screw placement accuracy. The fluoroscopy-aided pedicle screw placement technique still remains a practical, safe, and effective surgical method for thoracic and lumbar fixation.The risk of mal-positioning may be reduced with careful preoperative surgical planning, accurate knowledge of the spinal anatomy, surgical experience, and correct indication for conventional surgery. There have been many studies both illustrating institutional practices and pedicle screw placement accuracy, but due to differing definitions of breach and the lack of explicit control groups, many of these studies are difficult to interpret. For that, we hope to make conclusions regarding the using of APSM scoring system for determine the accuracy in pedicle screw placement. |