Korean J Spine.  2017 Sep;14(3):84-88. 10.14245/kjs.2017.14.3.84.

Cervical Pedicle Screw Placement Using Medial Funnel Technique

• Lee JH
• Choi BK
• Han IH
• Choi WG
• Nam KH
• Kim HS

• KMID: 2396044
• DOI: http://doi.org/10.14245/kjs.2017.14.3.84

Abstract

OBJECTIVE
Cervical pedicle screw (CPS) placement is very challenging due to high risk of neurovascular complications. We devised a new technique (medial funnel technique) to improve the accuracy and feasibility of CPS placement.
METHODS
We reviewed 28 consecutive patients undergoing CPS instrumentation using the medial funnel technique. Their mean age was 51.4 years (range, 30-81 years). Preoperative diagnosis included degenerative disease (n=5), trauma (n=22), and infection (n=1). Screw perforations were graded with the following criteria: grade 0 having no perforation, grade 1 having < 25%, grade 2 having 25%-50% and grade 3 having >50% of screw diameter. Grades 0 and 1 were considered as correct position. The degree of perforation was determined by 2 junior neurosurgeons and 1 senior neurosurgeon.
RESULTS
A total of 88 CPSs were inserted. The rate of correct placement was 94.3%; grade 0, 54 screws; grade 1, 29 screws; grade 2, 4 screws; and grade 3, 1 screw. No neurovascular complications or failure of instrumentation occurred. In perforated screws (34 screws), lateral perforations were 4 and medial perforations were 30.
CONCLUSION
We performed CPS insertion using medial funnel technique and achieved 94.3% (83 of 88) of correct placement. And it can decrease lateral perforation.

Keyword

Cervical vertebrae; Pedicle screws; Bone screws

MeSH Terms

Bone Screws
Cervical Vertebrae
Diagnosis
Female
Humans
Neurosurgeons
Pedicle Screws*