Iraqi Journal of Medical Sciences








Vol. 12 Issue 3 July - September / 2014
Published on website | Date : 2016-03-24 10:13:45

PEDICLE SCREW PLACEMENT VERSUS CLASSIC SURGERY IN LUMBOTHORACIC SPINE DISORDER

Abdulameer J. Al-Kafaji, Yasir M.H. Hamandi


Abstract

Background: Pedicular screw fixation surgery for thoracolumber disorders is well established surgical method to treat instability due to different etiologies due to trauma, infection, tumor as well as spondylopathic deformity.
Objective:To evaluate surgical modalities in the treatment of lumbothoracic disorders.
Methods: Prospective study of 30 patients 6 lower dorsal trauma, 2 treated by screw and 4 by decompressive laminectomy and bone graft using rib, 4 spondylolesthsis treated by screw and 8 cases by decompessive laminectomy and fusion, 4 spondylosis treated using screw and 8 treated only decompressive and foraminotomy .
Result:Spinal fusion using pedicle screws has become popular worldwide in treating a variety of disorders of the spine. Treatment of thoracolumbar fracture with pedicle screws at injury level is easy and worthy. Compared to the lumbar region, the insertion of thoracic pedicle screws remains a challenge, despite of modern technology and computer assistance especially in the upper thoracic spine, where misplacement rates of up to 40% CT-navigation leading to the conclusion that pedicle screw instrumentation in the middle and upper thoracic area should be carried out with the help of navigation only. The availability of an intraoperative CT seems to be of particular importance. An accurate assessment of screw positions becomes hereby possible without any significant time delay and with utmost accuracy.
Conclusions: Transpedicular fixation of thoracolumbar and lumbar spine fractures has become a frequently used technique. Transpedicular screw fixation provides the greatest stability in the unstable spine.
Keyword: Pedicle screw, accuracy, lower dorsal trauma, hydatid spine


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