{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T17:52:04Z","timestamp":1786125124500,"version":"build-2736575974"},"reference-count":32,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1","license":[{"start":{"date-parts":[[2018,9,5]],"date-time":"2018-09-05T00:00:00Z","timestamp":1536105600000},"content-version":"vor","delay-in-days":1,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"funder":[{"DOI":"10.13039\/501100004543","name":"China Scholarship Council","doi-asserted-by":"publisher","award":["2017-3109\/201708260068"],"award-info":[{"award-number":["2017-3109\/201708260068"]}],"id":[{"id":"10.13039\/501100004543","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["81460405"],"award-info":[{"award-number":["81460405"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"name":"5511 Innovation-driven Program of Jiangxi Province","award":["20165BCB18017"],"award-info":[{"award-number":["20165BCB18017"]}]},{"name":"Key Program of Jiangxi Province","award":["20152ACB21024"],"award-info":[{"award-number":["20152ACB21024"]}]}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":["Operative Surg.","ONSURG"],"published-print":{"date-parts":[[2019,7]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>BACKGROUND<\/jats:title>\n                    <jats:p>Biomechanical studies revealed that pedicle screw instrumentation has a superior stabilizing effect compared with other internal fixations in reconstructing the subaxial cervical spine. However, severe neurovascular risks preclude surgeons from routinely conducting pedicle screw manipulation in cervical spine.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>OBJECTIVE<\/jats:title>\n                    <jats:p>To evaluate the accuracy and safety of the lateral vertebral notch (LVN)-referred technique used in subaxial cervical pedicle screw (CPS) placement.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>One hundred thirty-five consecutive retrospective patients with cervical disorders underwent the LVN-referred technique for CPS placements in 3 spine centers. Postoperative pedicle perforations were confirmed by CT scans to assess the technical accuracy. Neurovascular complications derived from CPS misplacements were recorded to evaluate the technical safety.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>\n                      A total of 718 CPSs were inserted into subaxial cervical spine. Postoperative CT scans revealed that the accuracy of CPS placement was superior. Neither vertebral artery injury nor spinal cord injury occurred. One radiculopathy was from a unilateral C6 nerve root compression. A screw-related neurovascular injury rate of 0.7% occurred in this cohort. Additionally, there was no significant difference in the accuracy of CPS placement among 3 surgeons (H\u00a0=\u00a01.460,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u00a0=\u00a0.482). The relative standard deviation values revealed that technical reproducibility was acceptable. Furthermore, there was no significant difference between the patients\u2019 pedicle transverse angles and inserted CPS transverse angles from C3 to C7 (all\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u00a0&gt;\u00a0.05).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSION<\/jats:title>\n                    <jats:p>The LVN is a reliable and consistent anatomic landmark for CPS placement. The accuracy and safety of subaxial CPS placement by using LVN-referred technique are highly acceptable, which may endow this technique to be practicably performed in selected patients.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ons\/opy233","type":"journal-article","created":{"date-parts":[[2018,9,4]],"date-time":"2018-09-04T22:53:15Z","timestamp":1536101595000},"page":"52-60","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":8,"title":["Accuracy and Safety of Lateral Vertebral Notch-Referred Technique Used in Subaxial Cervical Pedicle Screw Placement"],"prefix":"10.1227","volume":"17","author":[{"given":"Zhimin","family":"Pan","sequence":"first","affiliation":[{"name":"Department of Orthopaedics, the Second Affiliated Hospital of Nanchang University, Nanchang, China"},{"name":"Department of Neurosurgery, Spine and Spinal Cord Institute, Yonsei University College of Medicine, Seoul, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Junlong","family":"Zhong","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, the Second Affiliated Hospital of Nanchang University, Nanchang, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shiming","family":"Xie","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, Mianyang Orthopaedic Hospital, Mianyang, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Limin","family":"Yu","sequence":"additional","affiliation":[{"name":"Department of Spine Surgery, Peking University Shenzhen Hospital, Shenzhen, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chunyang","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, the Second Affiliated Hospital of Nanchang University, Nanchang, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoon","family":"Ha","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Spine and Spinal Cord Institute, Yonsei University College of Medicine, Seoul, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Keung Nyun","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Spine and Spinal Cord Institute, Yonsei University College of Medicine, Seoul, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Youshan","family":"Zhang","sequence":"additional","affiliation":[{"name":"Computer of Science Engineering, Lehigh University, Bethlehem, Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6384-1227","authenticated-orcid":false,"given":"Kai","family":"Cao","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, the Second Affiliated Hospital of Nanchang University, Nanchang, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2019,7]]},"reference":[{"issue":"10","key":"bib1-20240909","doi-asserted-by":"crossref","first-page":"1458","DOI":"10.2106\/00004623-200010000-00013","article-title":"The use of pedicle-screw internal fixation for the operative treatment of spinal disorders","volume":"82-A","author":"Gaines","year":"2000","journal-title":"J Bone Joint Surg Am"},{"issue":"6","key":"bib2-20240909","doi-asserted-by":"crossref","first-page":"667","DOI":"10.1016\/j.spinee.2006.03.019","article-title":"Cervical pedicle screws vs. lateral mass screws: uniplanar fatigue analysis and residual pullout strengths","volume":"6","author":"Johnston","year":"2006","journal-title":"Spine J"},{"issue":"5","key":"bib3-20240909","doi-asserted-by":"crossref","first-page":"803","DOI":"10.1007\/s00586-010-1278-0","article-title":"Load sharing properties of cervical pedicle screw-rod constructs versus lateral mass screw-rod constructs","volume":"19","author":"Dunlap","year":"2010","journal-title":"Eur Spine J"},{"issue":"9","key":"bib4-20240909","doi-asserted-by":"crossref","first-page":"1914","DOI":"10.2106\/JBJS.G.01166","article-title":"Computerized tomographic morphometric analysis of subaxial cervical spine pedicles in young asymptomatic volunteers","volume":"90","author":"Rao","year":"2008","journal-title":"J Bone Joint Surg Am"},{"issue":"1","key":"bib5-20240909","doi-asserted-by":"crossref","first-page":"2","DOI":"10.1186\/1749-799X-9-2","article-title":"Unilateral instrumented fixation for cervical dumbbell tumors","volume":"20","author":"Ando","year":"2014","journal-title":"J Orthop Surg Res"},{"issue":"3","key":"bib6-20240909","doi-asserted-by":"crossref","first-page":"274","DOI":"10.3171\/2012.11.SPINE12417","article-title":"Surgical correction of severe cervical kyphosis in patients with neurofibromatosis Type 1","volume":"18","author":"Kawabata","year":"2013","journal-title":"J Neurosurg Spine"},{"issue":"1","key":"bib7-20240909","doi-asserted-by":"crossref","first-page":"35","DOI":"10.3171\/2014.11.SPINE14805","article-title":"A single-stage posterior approach with open reduction and pedicle screw fixation in subaxial cervical facet dislocations","volume":"23","author":"Park","year":"2015","journal-title":"J Neurosurg Spine"},{"issue":"3","key":"bib8-20240909","doi-asserted-by":"crossref","first-page":"387","DOI":"10.1007\/s00586-010-1589-1","article-title":"Posterior approach for cervical fracture-dislocations with traumatic disc herniation","volume":"20","author":"Nakashima","year":"2011","journal-title":"Eur Spine J"},{"issue":"4","key":"bib9-20240909","doi-asserted-by":"crossref","first-page":"280","DOI":"10.1097\/BRS.0000000000000133","article-title":"The safety and accuracy of free-hand pedicle screw placement in the subaxial cervical spine: a series of 45 consecutive patients","volume":"39","author":"Park","year":"2014","journal-title":"Spine"},{"issue":"8","key":"bib10-20240909","doi-asserted-by":"crossref","first-page":"962","DOI":"10.1097\/00007632-200004150-00011","article-title":"Complications of pedicle screw fixation in reconstructive surgery of the cervical spine","volume":"25","author":"Abumi","year":"2000","journal-title":"Spine"},{"issue":"9","key":"bib11-20240909","doi-asserted-by":"crossref","first-page":"1326","DOI":"10.1007\/s00586-009-1109-3","article-title":"Clinical accuracy of cervical pedicle screw insertion using lateral fluoroscopy: a radiographic analysis of the learning curve","volume":"18","author":"Yoshimoto","year":"2009","journal-title":"Eur Spine J"},{"issue":"7","key":"bib12-20240909","doi-asserted-by":"crossref","first-page":"1504","DOI":"10.1007\/s00586-013-2719-3","article-title":"The correlation between cervical range of motion and misplacement of cervical pedicle screws during cervical posterior spinal fixation surgery using a CT-based navigation system","volume":"22","author":"Tauchi","year":"2013","journal-title":"Eur Spine J"},{"issue":"10","key":"bib13-20240909","doi-asserted-by":"crossref","first-page":"2189","DOI":"10.1007\/s00586-014-3502-9","article-title":"Screw perforation features in 129 consecutive patients performed computer-guided cervical pedicle screw insertion","volume":"23","author":"Uehara","year":"2014","journal-title":"Eur Spine J"},{"key":"bib14-20240909","doi-asserted-by":"crossref","first-page":"2672","DOI":"10.12659\/MSM.894074","article-title":"Comparing accuracy of cervical pedicle screw placement between a guidance system and manual manipulation: A cadaver study","volume":"21","author":"Cong","year":"2015","journal-title":"Med Sci Monit"},{"issue":"20","key":"bib15-20240909","doi-asserted-by":"crossref","first-page":"2280","DOI":"10.1097\/01.brs.0000182275.31425.cd","article-title":"Cervical pedicle screws: conventional versus computer-assisted placement of cannulated screws","volume":"30","author":"Richter","year":"2005","journal-title":"Spine"},{"issue":"6","key":"bib16-20240909","doi-asserted-by":"crossref","first-page":"681","DOI":"10.3171\/2009.6.SPINE09352","article-title":"Cervical pedicle screw insertion using a computed tomography cutout technique","volume":"11","author":"Miyamoto","year":"2009","journal-title":"J Neurosurg Spine"},{"issue":"6","key":"bib17-20240909","doi-asserted-by":"crossref","first-page":"E341","DOI":"10.1097\/BRS.0000000000000772","article-title":"Safe and accurate midcervical pedicle screw insertion procedure with the patient-specific screw guide template system","volume":"40","author":"Kaneyama","year":"2015","journal-title":"Spine"},{"issue":"1","key":"bib18-20240909","doi-asserted-by":"crossref","first-page":"105","DOI":"10.1007\/s00586-009-1213-4","article-title":"Subaxial cervical pedicle screw insertion with newly defined entry point and trajectory: accuracy evaluation in cadavers","volume":"19","author":"Zheng","year":"2010","journal-title":"Eur Spine J"},{"issue":"5","key":"bib19-20240909","doi-asserted-by":"crossref","first-page":"459","DOI":"10.3340\/jkns.2012.52.5.459","article-title":"Cervical pedicle screw insertion using the technique with direct exposure of the pedicle by laminoforaminotomy","volume":"52","author":"Jo","year":"2012","journal-title":"J Korean Neurosurg Soc"},{"issue":"2","key":"bib20-20240909","doi-asserted-by":"crossref","first-page":"353","DOI":"10.1007\/s00586-011-1969-1","article-title":"Cervical pedicle screw insertion using a gutter entry point at the transitional area between the lateral mass and lamina","volume":"21","author":"Tofuku","year":"2012","journal-title":"Eur Spine J"},{"issue":"4","key":"bib21-20240909","doi-asserted-by":"crossref","first-page":"517","DOI":"10.1007\/s00402-017-2647-5","article-title":"The accuracy of the lateral vertebral notch-referred pedicle screw insertion technique in subaxial cervical spine: a human cadaver study","volume":"137","author":"Luo","year":"2017","journal-title":"Arch Orthop Trauma Surg"},{"key":"bib22-20240909","doi-asserted-by":"crossref","first-page":"322","DOI":"10.1016\/j.wneu.2017.04.054","article-title":"Coronal multiplane reconstructed computed tomography image determining lateral vertebral notch-referred pedicle screw entry point in subaxial cervical spine: a preclinical study","volume":"103","author":"Wu","year":"2017","journal-title":"World Neurosurg"},{"issue":"3","key":"bib23-20240909","doi-asserted-by":"crossref","first-page":"457","DOI":"10.1016\/j.spinee.2016.11.011","article-title":"Perforations and angulations of 324 cervical medial cortical pedicle screws: a possible guide to avoid lateral perforations with use of pedicle screws in lower cervical spine","volume":"17","author":"Mahesh","year":"2017","journal-title":"Spine J"},{"issue":"10","key":"bib24-20240909","doi-asserted-by":"crossref","first-page":"2166","DOI":"10.1007\/s00586-014-3470-0","article-title":"A multicenter study on accuracy and complications of freehand placement of cervical pedicle screws under lateral fluoroscopy in different pathological conditions: CT-based evaluation of more than 1,000 screws","volume":"23","author":"Hojo","year":"2014","journal-title":"Eur Spine J"},{"issue":"8","key":"bib25-20240909","doi-asserted-by":"crossref","first-page":"415","DOI":"10.1097\/BSD.0b013e3182309657","article-title":"Cervical pedicle screw placement using the \u201ckey slot technique\u201d: the feasibility and learning curve","volume":"25","author":"Lee","year":"2012","journal-title":"J Spinal Disord Tech"},{"issue":"4","key":"bib26-20240909","doi-asserted-by":"crossref","first-page":"280","DOI":"10.1097\/BRS.0b013e31822338ad","article-title":"Assessment of pedicle perforation by the cervical pedicle screw placement using plain radiographs","volume":"37","author":"Lee","year":"2012","journal-title":"Spine"},{"issue":"22","key":"bib27-20240909","doi-asserted-by":"crossref","first-page":"2456","DOI":"10.1097\/00007632-200111150-00012","article-title":"Accuracy of cervical pedicle screw placement using the funnel technique","volume":"26","author":"Karaikovic","year":"2001","journal-title":"Spine"},{"issue":"1","key":"bib28-20240909","doi-asserted-by":"crossref","first-page":"19","DOI":"10.1097\/00002517-199407010-00003","article-title":"Transpedicular screw fixation for traumatic lesions of the middle and lower cervical spine: description of the techniques and preliminary report","volume":"7","author":"Abumi","year":"1994","journal-title":"J Spinal Disord"},{"issue":"3","key":"bib29-20240909","doi-asserted-by":"crossref","first-page":"222","DOI":"10.1097\/00002517-199407030-00004","article-title":"Transpedicular screw fixation of articular mass fracture-separation: results of an anatomical study and operative technique","volume":"7","author":"Jeanneret","year":"1994","journal-title":"J Spinal Disord"},{"issue":"13","key":"bib30-20240909","doi-asserted-by":"crossref","first-page":"1655","DOI":"10.1097\/00007632-200007010-00009","article-title":"Placement of pedicle screws in the human cadaveric cervical spine: comparative accuracy of three techniques","volume":"25","author":"Ludwig","year":"2000","journal-title":"Spine"},{"issue":"20","key":"bib31-20240909","doi-asserted-by":"crossref","first-page":"2317","DOI":"10.1097\/00007632-199610150-00003","article-title":"Anatomic consideration of transpedicular screw placement in the cervical spine. An analysis of two approaches","volume":"21","author":"Miller","year":"1996","journal-title":"Spine"},{"issue":"1","key":"bib32-20240909","doi-asserted-by":"crossref","first-page":"148","DOI":"10.1007\/s00586-012-2494-6","article-title":"Accuracy of lower cervical pedicle screw placement with assistance of distinct navigation systems: a human cadaveric study","volume":"22","author":"Tian","year":"2013","journal-title":"Eur Spine J"}],"container-title":["Operative Neurosurgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/01787389-201907000-00007","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T16:50:36Z","timestamp":1786121436000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/01787389-201907000-00007"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,9,4]]},"references-count":32,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2019]]}},"URL":"https:\/\/doi.org\/10.1093\/ons\/opy233","relation":{},"ISSN":["2332-4252","2332-4260"],"issn-type":[{"value":"2332-4252","type":"print"},{"value":"2332-4260","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,9,4]]},"assertion":[{"value":"2018-01-18","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2018-07-27","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}