Perforation Rates of Cervical Pedicle Screw Inserted from C3 to C6 - A Retrospective Analysis of 78 Patients over a Period 5 of 14 Years -

Abstract

Cervical spine fixation using cervical pedicle screw (CPS) was first reported by Abumi [1] and Jeanneret [2] in 1994. Both reports described cases of cervical instability caused by cervical trauma. Cervical spine fixation by CPS was introduced as a procedure for the cervical instability of middle and/or lower cervical spine caused by trauma, and the importance of fixation by CPS for posterior cervical decompression and reconstruction was later reported [3,4]. Cervical pedicle screws can achieve rigid fixation compared to other cervical pedicle fixation methods [5, 6], and enable posterior cervical cord decompression. However, cervical pedicle screw insertion is technically demanding because of the narrow pedicle diameter and the risk of serious neurovascular complications including vertebral artery tear, spinal cord injury, and nerve root injury [7]. To achieve more accurate and safe pedicle screw insertion, navigation by two-dimensional imaging system or CT has been employed in recent years [9-12]. However, CPS insertion from C3 to C6 is technically demanding. The purpose of this study was to evaluate the perforation rates and direction of screw perforations in these insertions using CT-based navigation system.