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Updated: Jul 25, 2026
06:24
A Spine Robotic-Assisted Navigation System for Pedicle Screw Placement
Published on: May 11, 2020
9.2K
Acceptable errors with evaluation of 577 cervical pedicle screw placements.
Bijjawara Mahesh1, Bidre Upendra2, Rao Raghavendra1
1Vitus Spine Care And Research, Department of Spine Surgery, Bhagwan Mahaveer Jain Hospital, Vasanth Nagar, Bangalore, 560052, India.
Summary
Introducing an "acceptable errors classification" for cervical pedicle screws (CPS) reconciles high radiological perforation rates with low clinical complications. This new grading system demonstrates the safety and efficacy of CPS in spinal surgery.
Area of Science:
- Spine surgery
- Orthopedic surgery
- Neurosurgery
Background:
- Cadaveric studies indicate high cervical pedicle screw (CPS) misplacement rates, discouraging their use.
- Clinical outcomes, however, demonstrate minimal complications and highlight the benefits of CPS in cervical spine stabilization.
Purpose of the Study:
- To introduce and validate an "acceptable errors classification" system for CPS placement.
- To bridge the discrepancy between radiological perforation rates and clinical outcomes in CPS surgery.
Main Methods:
- Evaluated 577 CPS placements (C3-C7) in 99 patients using axial and sagittal CT reconstructions.
- Assessed screw placement accuracy using conventional grading and the novel "acceptable errors classification" system.
Main Results:
- Conventional grading revealed 25.64% perforations and 74.35% intrapedicular placements.
- The "acceptable errors classification" showed 91.68% acceptable placements and only 8.31% unacceptable placements.
Conclusions:
- The "acceptable errors classification" effectively reconciles high radiological perforation rates with low clinical complications.
- This classification supports the clinical safety and utility of CPS in cervical spine surgery, aligning with observed minimal complications despite radiological misplacements.
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