Syed Ahmad Faizan, Ajlan Ali, Tariq Imran, Zubair Mustafa, Muhammad Aqeel Natt, Asif Bashir.
Frequency of Misplacement of Percutaneously Placed Pedicle Screws in Thoracolumbar Fractures.
Pak J Neuro Surg Jan ;27(2):217-24.

Objective:To determine the frequency of misplacement of percutaneously placed screws in the management of thoracolumbar fractures.Material and Methods:A descriptive case series was conducted at the Department of Neurosurgery,Punjab Institute of Neurosciences, Lahore.The study comprised all individuals who had minimally invasive percutaneously implanted thoracic or lumbar pedicle screws placed. CT scans were conducted on the patient 24 hours after surgery as part of their usual post-operative care to capture axial pictures to find Pedicular cortical breaches in any direction.Results:Mean age of the patients was 32 years. 82.7% were male whereas 17.3% were females. We found that the frequency of misplacement was 10.9% in the management of thoracolumbar fractures.110 patients received 600 pedicle screws placed percutaneously. Of these,534 screws (89.1%) were ideally placed inside the pedicle. 7% showed minor pedicle penetration, 3.6% showed moderate pedicle penetration and only 0.3% showed severe penetration. Out of misplaced screws (10.9%), 7.3% of patients were between 15-40 years,and 3.6% were between 41-50 years. Out of misplaced screws (10.9%), 9.7% were male patients and 1.3% were female patients. For thoracic injury, 4.5% of patients suffered from misplaced screws, and for lumbar injury, 6.5% of patients were observed for misplaced screws (p-value: 0.008).Conclusion:The frequency of misplacement was 10.9% in the management of thoracolumbar fractures. The misplacement rate of the percutaneously placed screw is low. Therefore, we concluded that the percutaneously placed screw is safe to use.

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