End Vertebra Versus Apical Vertebra: Where Are We More Likely to Misplace in Spine Deformity?

This study seeks to evaluate the likelihood of screw misplacement at the end vertebra and apex. Methods: A retrospective review of preoperative and postoperative computed tomographic (CT) scans of spinal deformity patients who underwent posterior spinal fusion with pedicle screw constructs between 2004 and 2011 was performed. Pedicles located at the upper instrumented vertebra (UIV) and lower instrumented vertebra (LIV), and the major and minor apices were evaluated. Pedicle morphology was studied on preoperative CT and screw placement on postoperative CT. Results: In total, 188 patients met the inclusion criteria, 172 had preoperative CT scans and 133 had postoperative CT scans. The UIV had a significantly lower percentage of normal pedicles (type A) compared with apex major, apex minor, or LIV (59.1% vs. 76.1% vs. 77.3% vs. 98.7%; P
Source: Journal of Pediatric Orthopaedics - Category: Orthopaedics Tags: Scoliosis Source Type: research