Security of Pedicle Screws in Adolescent Idiopathic Scoliosis Surgical procedure.
Asian Backbone J. 2017 Dec;11(6):998-1007
Authors: Chan CYW, Kwan MK
To evaluate current publications on the protection of pedicle screw insertions in adolescent idiopathic scoliosis (AIS). Regardless of having elevated danger for neurological and visceral accidents, using pedicle screws have led to elevated correction charges in scoliosis surgical procedure. A evaluate was carried out on subjects pertinent to pedicle screw insertion in AIS, which included pedicle morphometry in AIS, constructions in danger throughout pedicle screw insertion, and accuracy and security of assorted pedicle screw insertion methods. The significance of laptop navigation and future analysis relating to pedicle screw placement in AIS had been additionally briefly reviewed. Many authors have reported irregular pedicle anatomy in AIS. Damage to the neural constructions was highest over the apical area, whereas aortic harm was the very best at T5 and T10. Within the proximal thoracic backbone, the esophagus could possibly be injured even with screws as quick as 25 mm. General pedicle perforation charges for perforations >zero and >2 mm (assessed by computed tomography) ranged from 6.four% to 65.zero% and three.7% to 29.9%, respectively. The vital pedicle perforation (>2 mm excluding lateral thoracic) and anterior perforation (>zero mm) charges was reported to vary from 1.5% to 14.5% and zero.zero% to 16.1%, respectively. Pedicle perforation charges had been decrease with using laptop navigation. The incidence of neurological hostile occasions after scoliosis surgical procedure was zero.06%-1.9%. Aortic harm has solely been noticed in case stories. In accordance with the accessible literature, pedicle screw insertion in AIS is taken into account protected with low charges of scientific hostile occasions. Furthermore, using navigation know-how has been proven to scale back pedicle perforation charges.
PMID: 29279757 [PubMed]