{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,3]],"date-time":"2026-11-03T15:20:18Z","timestamp":1793719218225,"version":"4.6.1"},"reference-count":21,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["SPI"],"published-print":{"date-parts":[[2006,12]]},"abstract":"<jats:sec>\n<jats:title>Object<\/jats:title>\n<jats:p>The authors conducted a study to introduce the imaging technique in which pedicle axis views are obtained using fluoroscopy to match the screw entry point with pedicle orientation and to report the clinical results and safety of cervical pedicle screw fixation (PSF) in patients treated for unstable cervical injuries.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>Methods<\/jats:title>\n<jats:p>One hundred consecutive patients with unstable cervical injuries underwent PSF in which the authors used fluoroscopic imaging to acquire pedicle axis views. There were 87 men and 13 women whose mean age was 42.5 years. The accuracy of PS placement was examined postoperatively using axial computed tomography (CT) and oblique radiography. Screw malpositioning was classified either as screw exposure (&lt; 50% of the screw outside the pedicle) or pedicle perforation (&gt; 50% of the screw outside the pedicle boundaries).<\/jats:p>\n<jats:p>The mean operative time was 97.6 minutes, and the mean estimated blood loss was 221 ml. Local vertebral alignment around the injured segment measured 6.0\u00b0 of kyphosis preoperatively and 6.7\u00b0 of lordosis postoperatively. Solid posterior bone fusion was achieved in all but three patients who died shortly after surgery. There was no secondary dislodgment of instrumentation in 95% of these 97 cases. Of the 419 cervical PSs, 43 (10.3%) were of the screw-exposure type and 17 (4.0%) of the pedicle-perforation type. There were two surgery-related complications: one penetration of a probe into the vertebral artery and one radiculopathy. There were six postoperative complications: two cases of instrumentation failure associated with loss of correction, three cases of correction loss (&gt; 10\u00b0), and one case of deep wound infection.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>Conclusions<\/jats:title>\n<jats:p>Solid posterior fusion without secondary dislodgment of hardware was demonstrated in 95% of the cases. The incidence of complications associated with cervical PSF was not high. Postoperative CT scanning showed that 17 (4.0%) of 419 screws perforated the pedicle. It appears that fluoroscopy performed using pedicle axis views improves the accuracy and safety of cervical PS insertion.<\/jats:p><\/jats:sec>","DOI":"10.3171\/spi.2006.5.6.488","type":"journal-article","created":{"date-parts":[[2008,1,24]],"date-time":"2008-01-24T12:23:01Z","timestamp":1201177381000},"page":"488-493","source":"Crossref","is-referenced-by-count":101,"title":["Cervical pedicle screw fixation in 100 cases of unstable cervical injuries: pedicle axis views obtained using fluoroscopy"],"prefix":"10.3171","volume":"5","author":[{"given":"Yasutsugu","family":"Yukawa","sequence":"first","affiliation":[{"name":"Department of Orthopedic Surgery, Chubu Rosai Hospital, Nagoya, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fumihiko","family":"Kato","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Chubu Rosai Hospital, Nagoya, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hisatake","family":"Yoshihara","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Chubu Rosai Hospital, Nagoya, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Makoto","family":"Yanase","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Chubu Rosai Hospital, Nagoya, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Keigo","family":"Ito","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Chubu Rosai Hospital, Nagoya, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1-0050488","series-title":"J Spinal Disord","doi-asserted-by":"publisher","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","year":"1994"},{"key":"b2-0050488","series-title":"Spine","doi-asserted-by":"publisher","first-page":"1853","DOI":"10.1097\/00007632-199708150-00010","article-title":"Pedicle screw fixation for nontraumatic lesions of the cervical spine","volume":"22","year":"1997"},{"key":"b3-0050488","series-title":"Spine","doi-asserted-by":"publisher","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","year":"2000"},{"key":"b4-0050488","series-title":"Spine","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1097\/00007632-198200710-00001","article-title":"A mechanistic classification of closed, indirect fractures and dislocations of the lower cervical spine","volume":"7","year":"1982"},{"key":"b5-0050488","series-title":"Spine","doi-asserted-by":"publisher","first-page":"2160","DOI":"10.1097\/00007632-200110010-00024","article-title":"Trans-pedicular screw placement: image-guided versus lateral-view fluoroscopy: in vitro simulation","volume":"26","year":"2001"},{"key":"b6-0050488","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"893","DOI":"10.3171\/jns.1989.70.6.0893","article-title":"Posterior cervical interspinous compression wiring and fusion for mid to low cervical spinal injuries","volume":"70","year":"1989"},{"key":"b7-0050488","series-title":"Spine","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1097\/00007632-199701010-00001","article-title":"Morphometric evaluation of lower cervical pedicle and its projection","volume":"22","year":"1997"},{"key":"b8-0050488","series-title":"J Spinal Disord","doi-asserted-by":"publisher","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","year":"1994"},{"key":"b9-0050488","series-title":"Spine","doi-asserted-by":"publisher","first-page":"977","DOI":"10.1097\/00007632-199705010-00009","article-title":"Cervical pedicle screws versus lateral mass screws. 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