A Novel Concept for the Best Coronal Alignment of Pedicle Screws in Multilevel Lumbar Posterior Instrumentation- A Technical Note - (다분절 요추 후방 기기술에서 척추경 나사못의 관상면상 정렬을 위한 삽입방법-술기보고-)

강석중; 황창주; 이성우; 안영준; 김영태; 이동호; 이춘성

A Novel Concept for the Best Coronal Alignment of Pedicle Screws in Multilevel Lumbar Posterior Instrumentation- A Technical Note -

Journal of Korean Society of Spine Surgery
Abbr : J Kor Spine Sur
2008, 15(2), pp.96-101
Publisher : Korean Society Of Spine Surgery
Research Area : Medicine and Pharmacy > Orthopedic Surgery

강석중 ¹, 황창주 ², 이성우 ², 안영준 ³, 김영태 ², 이동호 ², 이춘성 ²

¹인제의대
²울산의대
³경찰병원

Candidate

ABSTRACT

Correct alignment of pedicle screws is imperative in multilevel instrumentation. However, there has been no report addressingthe technical aspects of this subject. If the head diameter of a pedicle screw is D, the head height is H, and the convergenceangle of the screw being inserted is α, then the distance between the extension line of the medial borders of the inserted screwheads and the insertion point of the adjacent screw (A) is described by the following formula:A = ½ Dcos α- Hsin αIf an L3 pedicle screw (D=13 mm, H=15 mm) is to be inserted with a convergence angle of 14 degrees after the insertion of L4and L5 screws, its insertion point should be 3.6 mm medial to the extension line of the centers of the L4 and L5 screws and 2.7mm lateral to the extension line of their medial borders for all screw heads, so it can be aligned in the coronal plane. In order toachieve the best alignment, a pedicle screw is inserted between the extended line of the centers and that of the medial bordersof the inserted adjacent screw heads. For the routine range of convergence angles, it is essential to move the entry point medial-ly toward the extended line connecting the medial borders of the inserted adjacent screw heads.

KEYWORDS

Pedicle screw, Coronal alignment, Entry point, Multilevel posterior lumbar instrumentation

Citation status

* References for papers published after 2023 are currently being built.

[journal] Zindrick MR / 1987 / Analysis of the morphometric characteristics of the thoracic and lumbar pedicles / Spine 12 : 160~166

[journal] Suk SI / 2001 / Thoracic pedicle screw fixation in spinal deformities / Spine 26 : 2049~2057

[journal] Park HJ / 1999 / Entry point of pedicle screw in the lumbar spine / J Korean Soc Spine Surg 6 : 349~354

[journal] Krag MH / 1991 / Biomechanics of thoracolumbar spinal fixation / Spine 16 : 84~99

[journal] Magerl FP / 1984 / Stabilization of the lower thoracic and lumbar spine with external skeletal fixation / Clin Orthop 189 : 125~141

[journal] Roy-Camille R / 1986 / Internal fixation of the lumbar spine with pedicle screw plating / Clin Orthop 203 : 7~17

[journal] Ebraheim NA / 1997 / Anatomic relation between the lumbar pedicle and the adjacent neural structures / Spine 22 : 2338~2341

[journal] Attar A / 2001 / Lumbar pedicle: surgical anatomic evaluation and relationships / Eur spine J 10 : 10~15

[journal] Soyuncu Y / 2005 / Anatomic evaluation and relationship between the lumbar pedicle and adjacent neural structures / J Spinal Disord Tech 18 : 243~246

[journal] Stanford RE / 2004 / Multiaxial pedicle screw designs: Static and dynamic mechanical testing / Spine 29 : 367~375

[journal] Shepard MF / 2002 / Effects of polyaxial pedicle screws on lumbar construct rigidity / J Spinal Disord Tech 15 : 233~236

[journal] Kuklo TR / 2005 / Monaxial versus multiaxial thoracic pedicle screws in the correction of adolescent idiopathic scoliosis / Spine 30 : 2113~2120

KJCKorea
Journal Central

Journal of Korean Society of Spine Surgery 2023 KCI Impact Factor : 0.03