Comparison of open and percutaneous navigated pedicle screw placement for traumatic injuries of the subaxial cervical spine.

INTRODUCTION

Cervical pedicle screw (CPS) placement is a technically demanding procedure with a high risk of neurovascular injuries in case of screw misplacement. In contrast to the thoracolumbar spine, there is limited data on percutaneous pedicle screw placement in the cervical spine.

RESEARCH QUESTION: This study aims to compare the accuracy, blood loss and duration of surgery for open and percutaneous CPS placement for traumatic injuries of the subaxial cervical spine.

MATERIALS AND

METHODS

In this retrospective single-center study, 22 patients undergoing percutaneous CPS placement were compared to a control group of 18 patients treated with open CPS placement. The screw position was analyzed in postoperative CT scans using the Neo and Bredow classifications. Additionally, intraoperative radiation exposure, duration of surgery, and blood loss were evaluated.

RESULTS

The overall accuracy (perforation <2 mm) was 89.71 % for percutaneous and 89.29 % for open CPS placement (p > 0.99). None of the misplaced screws resulted in neurovascular injuries. One patient in the control group underwent revision surgery due to screw misplacement. The mean duration of surgery and intraoperative blood loss were lower in percutaneous compared to open procedures. There was no significant difference in intraoperative radiation exposure between the two groups.

DISCUSSION AND

CONCLUSION

The results suggest that percutaneous CPS placement in the subaxial spine is feasible with similar accuracy compared to open CPS placement. Further studies are needed to evaluate long-term clinical outcomes.