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European Spine Journal

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01-05-2012 | Original Article

Free-hand pedicle screws insertion technique in the treatment of 120 consecutive scoliosis cases operated without use of intraoperative neurophysiological monitoring

Authors: Marco Crostelli, Osvaldo Mazza, Massimo Mariani

Published in: European Spine Journal | Special Issue 1/2012

Abstract

Purpose

We present 120 patients (37 males, 83 females) affected by thoracic lumbar scoliosis, treated by posterior instrumented arthrodesis with the insertion of pedicle screws by “free hand technique”, without any image guided system, radioscopy use during insertion or intraoperative neurophysiological monitoring.

Methods

Seventy-two (60%) patients have been treated by hybrid instrumentation with lumbar and thoracic screws, hooks and wires at thoracic levels, while the remaining 48 (40%) patients have used only lumbar and thoracic pedicle screws. Mean Cobb grades value of the main scoliotic curve was 73° before surgery in patients treated by hybrid instrumentation, reduced to 37.5° after surgery. In patients treated only by screws, mean Cobb grades value of the main scoliotic curve was 65°, reduced to 16° after surgery.

Results

Minimum follow up has been 3 years; mean patient age at surgery was 15 years and 4 months. We placed a total number of 1,004 pedicle screws, 487 of which at thoracic level. In 12 patients (10%) a total number of 20 screws were misplaced at postoperatory exam, without any clinical complication for the patients or consequences on the arthrodesis or on maintaining the correction of the curve.

Conclusions

In our experience pedicle screws is the method that leads to best correction and balance on vertebral bodies, with best results at distance concerning correction maintaining. Our experience shows that even at thoracic level, pedicle screws insertion by free-hand technique is safe and reliable.

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Title: Free-hand pedicle screws insertion technique in the treatment of 120 consecutive scoliosis cases operated without use of intraoperative neurophysiological monitoring
Authors: Marco Crostelli
Osvaldo Mazza
Massimo Mariani
Publication date: 01-05-2012
Publisher: Springer-Verlag
Published in: European Spine Journal / Issue Special Issue 1/2012
Print ISSN: 0940-6719
Electronic ISSN: 1432-0932
DOI: https://doi.org/10.1007/s00586-012-2218-y

At a glance: The STEP trials

Springer Medicine

Free-hand pedicle screws insertion technique in the treatment of 120 consecutive scoliosis cases operated without use of intraoperative neurophysiological monitoring

Abstract

Purpose

Methods

Results

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

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