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J Korean Neurosurg Soc. 2012 Jan;51(1):66-70. English. Original Article.
Hyun SJ , Kim YJ , Cheh G , Yoon SH , Rhim SC .
Department of Neurosurgery, Spine Center, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea.
Department of Neurosurgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Department of Orthopedic Surgery, Wooridul Spine Hospital, Seoul, Korea.
Department of Neurosurgery, College of Medicine, Inha University, Incheon, Korea.
Department of Orthopaedic Surgery, Spine Service, Columbia University College of Physicians and Surgeons, New York, NY, USA.

Thoracic pedicle screw fixation techniques are still controversial for thoracic deformities because of possible complications including neurologic deficit. Methods to aid the surgeon in appropriate screw placement have included the use of intraoperative fluoroscopy and/or radiography as well as image-guided techniques. We describe our technique for free hand pedicle screw placement in the thoracic spine without any radiographic guidance and present the results of pedicle screw placement analyzed by computed tomographic scan in two human cadavers. This free hand technique of thoracic pedicle screw placement performed in a step-wise, consistent, and compulsive manner is an accurate, reliable, and safe method of insertion to treat a variety of spinal disorders, including spinal deformity.

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