Comparison of superior-level facet joint violations during open and percutaneous pedicle screw placement.
| dc.contributor.author | Babu, Ranjith | |
| dc.contributor.author | Park, Jong G | |
| dc.contributor.author | Mehta, Ankit I | |
| dc.contributor.author | Shan, Tony | |
| dc.contributor.author | Grossi, Peter M | |
| dc.contributor.author | Brown, Christopher R | |
| dc.contributor.author | Richardson, William J | |
| dc.contributor.author | Isaacs, Robert E | |
| dc.contributor.author | Bagley, Carlos A | |
| dc.contributor.author | Kuchibhatla, Maragatha | |
| dc.contributor.author | Gottfried, Oren N | |
| dc.date.accessioned | 2024-08-15T13:18:54Z | |
| dc.date.available | 2024-08-15T13:18:54Z | |
| dc.date.issued | 2012-11 | |
| dc.description.abstract | BackgroundSuperior-level facet joint violation by pedicle screws may result in increased stress to the level above the instrumentation and may contribute to adjacent segment disease. Previous studies have evaluated facet joint violations in open or percutaneous screw cases, but there are no reports describing a direct institutional comparison.ObjectiveTo compare the incidence of superior-level facet violation for open vs percutaneous pedicle screws and to evaluate patient and surgical factors that affect this outcome.MethodsWe reviewed 279 consecutive patients who underwent an index instrumented lumbar fusion from 2007 to 2011 for degenerative spine disease with stenosis with or without spondylolisthesis. We used a computed tomography grading system that represents progressively increasing grades of facet joint violation. Patient and surgical factors were evaluated to determine their impact on facet violation.ResultsOur cohort consisted of 126 open and 153 percutaneous cases. Percutaneous procedures had a higher overall violation grade (P = .02) and a greater incidence of high-grade violations (P = .006) compared with open procedures. Bivariate analysis showed significantly greater violations in percutaneous cases for age < 65 years, obesity, pedicle screws at L4, and 1- and 2-level surgeries. Multivariate analysis showed the percutaneous approach and depth of the spine to be independent risk factors for high-grade violations.ConclusionThis study demonstrates greater facet violations for percutaneously placed pedicle screws compared with open screws. | |
| dc.identifier.issn | 0148-396X | |
| dc.identifier.issn | 1524-4040 | |
| dc.identifier.uri | ||
| dc.language | eng | |
| dc.publisher | Ovid Technologies (Wolters Kluwer Health) | |
| dc.relation.ispartof | Neurosurgery | |
| dc.relation.isversionof | 10.1227/neu.0b013e31826a88c8 | |
| dc.rights.uri | ||
| dc.subject | Lumbar Vertebrae | |
| dc.subject | Zygapophyseal Joint | |
| dc.subject | Humans | |
| dc.subject | Postoperative Complications | |
| dc.subject | Tomography, X-Ray Computed | |
| dc.subject | Treatment Outcome | |
| dc.subject | Spinal Fusion | |
| dc.subject | Logistic Models | |
| dc.subject | Cohort Studies | |
| dc.subject | Bone Screws | |
| dc.subject | Internal Fixators | |
| dc.subject | Middle Aged | |
| dc.subject | Female | |
| dc.subject | Male | |
| dc.title | Comparison of superior-level facet joint violations during open and percutaneous pedicle screw placement. | |
| dc.type | Journal article | |
| duke.contributor.orcid | Richardson, William J|0000-0001-9608-199X|0000-0002-8750-7263|0009-0003-7526-7797 | |
| pubs.begin-page | 962 | |
| pubs.end-page | 970 | |
| pubs.issue | 5 | |
| pubs.organisational-group | Duke | |
| pubs.organisational-group | School of Medicine | |
| pubs.organisational-group | Faculty | |
| pubs.organisational-group | Basic Science Departments | |
| pubs.organisational-group | Clinical Science Departments | |
| pubs.organisational-group | Institutes and Centers | |
| pubs.organisational-group | Biostatistics & Bioinformatics | |
| pubs.organisational-group | Orthopaedic Surgery | |
| pubs.organisational-group | Psychiatry & Behavioral Sciences | |
| pubs.organisational-group | University Initiatives & Academic Support Units | |
| pubs.organisational-group | University Institutes and Centers | |
| pubs.organisational-group | Duke Global Health Institute | |
| pubs.organisational-group | Center for the Study of Aging and Human Development | |
| pubs.organisational-group | Initiatives | |
| pubs.organisational-group | Neurosurgery | |
| pubs.organisational-group | Duke Innovation & Entrepreneurship | |
| pubs.organisational-group | Psychiatry & Behavioral Sciences, Behavioral Medicine & Neurosciences | |
| pubs.organisational-group | Biostatistics & Bioinformatics, Division of Biostatistics | |
| pubs.publication-status | Published | |
| pubs.volume | 71 |
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