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Axis Neuromonitoring Axis Neuromonitoring

Evaluating Pedicle Screw Misplacement

By Admin | June 09, 2016

A review of patient charts, x-rays, and CT scans evaluated the accuracy of pedicle screw placement in order to gauge the relationship of screw misplacement with morbidity.

Of the 2,724 pedicle screws reviewed:

  • 87.96% (2.396 screws) were placed accurately.
  • 9.07% (247 screws) were considered benign misplacements.
  • 1.91% (52 screws) were considered indeterminate misplacements.
  • And 1.06% (29 screws) were considered at risk.

These screws were from 127 patients. Looking at those numbers:

  • Only 18.11% (23 patients) had all screws placed accurately.
  • 27.6% (35 patients) had screws at risk.
  • Over 40% of patients had screws with concerns.

Per-patient analysis seems worse than per-screw analysis. And with the increasing use of spinal fusions and the use of pedicle screws, better strategies for screw-placement evaluation are needed.

Information for this posting was taken from “Are We Underestimating the Significance of Pedicle Screw Misplacement?” in Spine Journal May 2016 - Volume 41 - Issue 9 - p E548–E555.

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