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Archives of Orthopaedic and Trauma Surgery

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Open Access 01-07-2012 | Orthopaedic Surgery

Cervical lateral mass screw fixation without fluoroscopic control: analysis of risk factors for complications associated with screw insertion

Authors: Shinichi Inoue, Tokuhide Moriyama, Toshiya Tachibana, Fumiaki Okada, Keishi Maruo, Yutaka Horinouchi, Shinichi Yoshiya

Published in: Archives of Orthopaedic and Trauma Surgery | Issue 7/2012

Abstract

Objective

To examine the outcome of cervical lateral mass screw fixation focusing on analysis of the risk factors for screw-related complications.

Methods

Ninety-four patients who underwent posterior cervical fixation with a total of 457 lateral mass screws were included in the study. The lateral mass screws were placed using a modified Magerl method. Computed tomographic (CT) images were taken in the early postoperative period in all patients, and the screw trajectory angle was measured on both axial and sagittal plane images.

Results

In the postoperative CT analysis for the screw trajectory, 56.5 % of the screws were directed within the acceptable range (within 21–40° on both axial and sagittal planes). As intraoperative screw-associated complications, 9.6 % of the screws were found to contact with or breach the vertebral artery foramen. In this group, the screw trajectory angle on axial plane was significantly lower than in the group without contact. Facet violation was observed in 13 screws (2.8 %). This complication was associated with a significantly lower trajectory angles in the sagittal plane, predominantly at C6 level (69.2 %). In the patient chart review, no serious neurovascular injuries were documented.

Conclusions

In the analysis of potential risk factors for violation of the VA foramen as well as FV during screw insertion, the former incidence was significantly related to the screw trajectory angle (lack of lateral angulation) in the axial plane, while the latter incidence was related to a poor screw trajectory angle in the sagittal plane.

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Title: Cervical lateral mass screw fixation without fluoroscopic control: analysis of risk factors for complications associated with screw insertion
Authors: Shinichi Inoue
Tokuhide Moriyama
Toshiya Tachibana
Fumiaki Okada
Keishi Maruo
Yutaka Horinouchi
Shinichi Yoshiya
Publication date: 01-07-2012
Publisher: Springer-Verlag
Published in: Archives of Orthopaedic and Trauma Surgery / Issue 7/2012
Print ISSN: 0936-8051
Electronic ISSN: 1434-3916
DOI: https://doi.org/10.1007/s00402-012-1507-6

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Cervical lateral mass screw fixation without fluoroscopic control: analysis of risk factors for complications associated with screw insertion

Abstract

Objective

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Objective

Methods

Results

Conclusions

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