Radiographic criteria for placement of translaminar facet screws

The Spine Journal : Official Journal of the North American Spine Society
Frank M PhillipsBenjamin W Cunningham

Abstract

Screw fixation of the facet joint has been reported to stabilize the lumbar spine and facilitate spinal fusion. Accurate placement of translaminar facet screws (TLFSs) requires identification of the posterior spinal elements, and the facet joints in particular, which may be facilitated by intra-operative fluoroscopy. The purpose of this study was to define the radiographic parameters that will allow for successful placement of TLFSs. Eighteen TLFSs were placed in three human cadaver spines using fluoroscopic guidance, with screws placed from L3-L4 to L5-S1 bilaterally. After screw placement, the spines were dissected and examined for accuracy of screw placement. In the first cadaver spine, TLFSs were placed with direct visualization of the posterior lumbar spine, during which a fluoroscopic image intensifier was used to define the appropriate radiographic parameters for safe placement of the screws. Bilateral TLFSs were then placed percutaneously using the radiographic parameters developed, after which the spines were dissected to examine the positions of the screws. The radiographic views identified to achieve proper TLFS placement were a true lateral, anteroposterior (AP), a 45-degree oblique and an AP view with the X-ray bea...Continue Reading

Citations

Aug 28, 2019·The Journal of International Medical Research·Yong HuXu-Guo Chen
Oct 19, 2016·Clinical Spine Surgery : a Spine Publication·Erik V de Kelft

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