A safe and simple method for pedicle screw insertion

Recently the pedicle screw has become increasingly popular because of good purchase in spinal instrumentation. The most feared complications in pedicle screw insertion are nerve root, cord, dura and vascular injuries. The aim of this study was reduction of the incidence of complications by making use of a simple and safe method. 92 patients with 332 pedicle screws insertion were treated between 1999 and 2002 by our technique. In this technique after identification and perforation of entry point, a 4.5 cortical screw (or 4N.schanse) is inserted in pedicle, image is used to verify correct position and finally the cortical screw (or schanse) is replaced by pedicle screw.The collected data were analyzed by T-student statisticaltes (P≤5%) From 332 Inserted pedicale screws only four (1.2%) screws had incorrect position that were corrected after image control. 2 screws from the 4 ones were from spondylolisthesis Grade III and 2 were related to idiopathic scoliosis. No complications were shown such as pedicle fracture, dura rupture or neural, spiral cord and vascular injuries. This method is simple and safe because of easy application and low or zero rate of complications.