-transparent.png){kind=logo}
METHODS Retrospective evaluation of complications in 180 consecutive patients with cervical disorders who had been treated by using pedicle screw fixation systems. OBJECTIVE To determine the risks associated with pedicle screw fixation in the cervical spine and to emphasize the importance of preoperative planning and surgical techniques in reducing the risks of this procedure. BACKGROUND Generally, pedicle screw fixation in the cervical spine has been considered too risky for the neurovascular structures. There have been several reports describing the complications of lateral mass screw-plate fixation. However, no studies have examined in detail the complications associated with cervical pedicle screw fixation. METHODS One hundred eighty patients who underwent cervical reconstructive surgery using cervical pedicle screw fixation were reviewed to clarify the complications associated with the pedicle screw fixation procedure. Cervical disorders were spinal injuries in 70 patients and nontraumatic lesions in 110 patients. Seven hundred twelve screws were inserted into the cervical pedicles, and the locations of 669 screws were radiologically evaluated. RESULTS Injury of the vertebral artery occurred in one patient. The bleeding was stopped by bone wax, and no neurologic complication developed after surgery. On computed tomographic (CT) scan, 45 screws (6.7%) were found to penetrate the pedicle, and 2 of 45 screws caused radiculopathy. Besides these three neurovascular complications directly attributed to screw insertion, radiculopathy caused by iatrogenic foraminal stenosis from excessive reduction of the translational deformity was observed in one patient. CONCLUSIONS The incidence of the clinically significant complications caused by pedicle screw insertion was low. Complications associated with cervical pedicle screw fixation can be minimized by sufficient preoperative imaging studies of the pedicles and strict control of screw insertion. Pedicle screw fixation is a useful procedure for reconstruction of the cervical spine in various kinds of disorders and can be performed safely.
K Abumi, and
Y Shono, and
M Ito, and
H Taneichi, and
Y Kotani, and
K Kaneda
August 2008,
American journal of orthopedics (Belle Mead, N.J.),
K Abumi, and
Y Shono, and
M Ito, and
H Taneichi, and
Y Kotani, and
K Kaneda
April 2012,
Journal of clinical neuroscience : official journal of the Neurosurgical Society of Australasia,
K Abumi, and
Y Shono, and
M Ito, and
H Taneichi, and
Y Kotani, and
K Kaneda
August 1997,
Spine,
K Abumi, and
Y Shono, and
M Ito, and
H Taneichi, and
Y Kotani, and
K Kaneda
July 1994,
The Journal of bone and joint surgery. British volume,
K Abumi, and
Y Shono, and
M Ito, and
H Taneichi, and
Y Kotani, and
K Kaneda
March 2006,
European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society,
K Abumi, and
Y Shono, and
M Ito, and
H Taneichi, and
Y Kotani, and
K Kaneda
June 2003,
Clinical orthopaedics and related research,
K Abumi, and
Y Shono, and
M Ito, and
H Taneichi, and
Y Kotani, and
K Kaneda
September 2007,
Clinical orthopaedics and related research,
K Abumi, and
Y Shono, and
M Ito, and
H Taneichi, and
Y Kotani, and
K Kaneda
July 2003,
Zhongguo xiu fu chong jian wai ke za zhi = Zhongguo xiufu chongjian waike zazhi = Chinese journal of reparative and reconstructive surgery,
K Abumi, and
Y Shono, and
M Ito, and
H Taneichi, and
Y Kotani, and
K Kaneda
May 1991,
Spine,
K Abumi, and
Y Shono, and
M Ito, and
H Taneichi, and
Y Kotani, and
K Kaneda
October 1995,
The Journal of the American Academy of Orthopaedic Surgeons,
