A study published in the April 2014 issue of The Journal of Spinal Disorders & Techniques examines incidence of pedicle screw placement close to vital structures to identify characteristics that increased the risk of screw misplacement.
The study covered 2,132 screws in 101 patients who underwent posterior spinal fusion for deformity. A total of 40 at-risk screws were identified in 25 patients. There were 31 screws in proximity of the aorta, one in the proximity of the left subclavian artery, three in the proximity of the trachea, one in the proximity of the pleura and one in the proximity of the diaphragm.
All of the misplaced screws were in the thoracic spine, and 50 percent were misplaced laterally. Half of the misplaced screws were 35 mm long and 57.5 percent were in pedicles with normal morphology. Around 75 percent of the screws were in curves between 40 and 70 degrees.
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