Journal of Korean Neurosurgical Society

The Korean Neurosurgical Society (대한신경외과학회)
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Comparison of Three Different Techniques in Cervical Transpedicular Screw Insertion

  • Seo, Young-Jun (Departments of Neurosurgery, School of Medicine, Pusan National University) ;
  • Song, Geun-Sung (Departments of Neurosurgery, School of Medicine, Pusan National University) ;
  • Cho, Won-Ho (Departments of Neurosurgery, School of Medicine, Pusan National University) ;
  • Choi, Byung-Kwan (Departments of Neurosurgery, School of Medicine, Pusan National University) ;
  • Cha, Seung-Heon (Departments of Neurosurgery, School of Medicine, Pusan National University) ;
  • Baek, Sun-Yong (Departments of Anatomy, School of Medicine, Pusan National University)
  • Published : 2006.05.30
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Abstract

Objective : This is a cadaver study to assess the accuracy of three cervical screw insertion techniques; the blind technique [Group I], the laminotomy technique [Group II], and the funnel technique [Group III]. Methods : Ten human cadavers embalmed with formaldehyde were prepared. After exposing the spinous processes, the laminas and the lateral masses, titanium alloy transpedicular screws were inserted from C3 to C7. A total of 100 pedicles were ramdomly assigned to one of three techniques [the blind technique : 31 screws, the laminotomy technique : 51 screws, the funnel technique: 18 screws]. Axial computed tomography with 1-mm slices, and sagittal and coronal reformation were performed to identify the accuracy of the screw insertion and the anatomic relationships. Results : In Group I, 9 screws [29%] were either contained within or penetrated less than 1mm, which were rated as successful. In Group II, 24 screws [47%] were successful. In Group III, 16 screws [89%] were successful. In the multiple comparison, there was a statistically significant difference between Groups I and III and between Groups II and III [$X^2$ test and Bonfenoni test]. Conclusion : The funnel technique can help a surgeon's understanding about the cervical pedicle more precisely than the other two techniques. The funnel technique is less dependent on lateral soft tissue retraction state.

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References

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