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학제간연구 과학기술학 뇌인지과학 기술정책 기타 복합학

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논문 기본 정보

자료유형
학술저널
저자정보
Akyoldas, Goktug (Department of Neurosurgery, Koc University) Senturk, Salim (Department of Neurosurgery, Koc University) Yaman, Onur (Department of Neurosurgery, Koc University) Ozdemir, Nail (Department of Neurosurgery, Tepecik Education and Training Hospital) Acaroglu, Emre (Department of Orthopedics, Memorial Hospital)
저널정보
대한신경외과학회 대한신경외과학회지 대한신경외과학회지 제61권 제5호
발행연도
2018.1
수록면
568 - 573 (6page)

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Objective : Thoracic pedicles have special and specific properties. In particular, upper thoracic pedicles are positioned in craniocaudal plane. Therefore, manipulation of thoracic pedicle screws on the left side is difficult for right-handed surgeons. We recommend a new position to insert thoracic pedicle screw that will be much comfortable for spine surgeons. Methods : We retrospectively reviewed 33 patients who underwent upper thoracic pedicle screw instrumentation. In 15 patients, a total of 110 thoracic pedicle screws were inserted to the upper thoracic spine (T1-6) with classical position (anesthesiologist and monitor were placed near to patient's head. Surgeons were standing classically near to patient's body while patients were lying in prone position). In 18 patients, a total of 88 thoracic pedicle screws were inserted to the upper thoracic spine with the new standing position-surgeons stand by the head of the patient and the anesthesia monitor laterally and under patient's belt level. All the operations performed by the same senior spine surgeons with the help of C-arm. Postoperative computed tomography scans were obtained to assess the screw placement. The screw malposition and pedicle wall violations were divided and evaluated separately. Cortical penetration were measured and graded at either : 1-2 mm penetration, 2-4 mm penetration and >4 mm penetration. Results : Total 198 screws were inserted with two different standing positions. Of 198 screws 110 were in the classical positioning group and 88 were in the new positioning group. Incorrect screw placement was found in 33 screws (16.6%). The difference between total screw malposition by both standing positions were found to be statistically significant (p=0.011). The difference between total pedicle wall violations by both standing positions were found to be statistically significant (p=0.003). Conclusion : Right-handedness is a problem during the upper thoracic pedicle screw placement on the left side. Changing the surgeon's position standing near to patient's head could provide a much comfortable position to orient the craniocaudal plane of the thoracic pedicles.
#Thoracic vertebrae #Pedicle screws #Right handed #Positioning

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참고문헌 (20)

참고문헌 신청
Belmont PJ Jr / 2001 / In vivo accuracy of thoracic pedicle screws / Spine (Phila Pa 1976) 26:2340~2346 Crossref Costa F / 2013 / Primary stability of pedicle screws depends on the screw positioning and alignment / Spine J 13:1934~1939 Crossref Di Silvestre M / 2007 / Complications of thoracic pedicle screws in scoliosis treatment / Spine (Phila Pa 1976) 32:1655~1661 Crossref Fisher CG / 2006 / Accuracy and safety of pedicle screw fixation in thoracic spine trauma / J Neurosurg Spine 5:520~526 Crossref Gertzbein SD / 1990 / Accuracy of pedicular screw placement in vivo / Spine (Phila Pa 1976) 15:11~14 Crossref

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