caa a22 4500 445833084 CHVBK 20180317145321.0 cr unu---uuuuu 170323e20111001xx s 000 0 eng 10.1007/s00586-011-1892-5 doi (NATIONALLICENCE)springer-10.1007/s00586-011-1892-5 Factors affecting the accurate placement of percutaneous pedicle screws during minimally invasive transforaminal lumbar interbody fusion [Elektronische Daten] [Moon-Chan Kim, Hung-Tae Chung, Jae-Lim Cho, Dong-Jun Kim, Nam-Su Chung] We retrospectively evaluated 488 percutaneous pedicle screws in 110 consecutive patients that had undergone minimally invasive transforaminal lumbar interbody fusion (MITLIF) to determine the incidence of pedicle screw misplacement and its relevant risk factors. Screw placements were classified based on postoperative computed tomographic findings as "correct”, "cortical encroachment” or as "frank penetration”. Age, gender, body mass index, bone mineral density, diagnosis, operation time, estimated blood loss (EBL), level of fusion, surgeon's position, spinal alignment, quality/quantity of multifidus muscle, and depth to screw entry point were considered to be demographic and anatomical variables capable of affecting pedicle screw placement. Pedicle dimensions, facet joint arthritis, screw location (ipsilateral or contralateral), screw length, screw diameter, and screw trajectory angle were regarded as screw-related variables. Logistic regression analysis was conducted to examine relations between these variables and the correctness of screw placement. The incidence of cortical encroachment was 12.5% (61 screws), and frank penetration was found for 54 (11.1%) screws. Two patients (0.4%) with medial penetration underwent revision for unbearable radicular pain and foot drop, respectively. The odds ratios of significant risk factors for pedicle screw misplacement were 3.373 (95% CI 1.095-10.391) for obesity, 1.141 (95% CI 1.024-1.271) for pedicle convergent angle, 1.013 (95% CI 1.006-1.065) for EBL >400cc, and 1.003 (95% CI 1.000-1.006) for cross-sectional area of multifidus muscle. Although percutaneous insertion of pedicle screws was performed safely during MITLIF, several risk factors should be considered to improve placement accuracy. Springer-Verlag, 2011 Risk factor nationallicence Percutaneous nationallicence Pedicle screw nationallicence Minimally invasive nationallicence TLIF nationallicence Kim Moon-Chan Department of Orthopaedic Surgery, Bumin Hospital, Busan, Korea aut Chung Hung-Tae Department of Orthopaedic Surgery, Bumin Hospital, Busan, Korea aut Cho Jae-Lim Department of Orthopaedic Surgery, Bumin Hospital, Busan, Korea aut Kim Dong-Jun Department of Orthopaedic Surgery, Bumin Hospital, Busan, Korea aut Chung Nam-Su Department of Orthopaedic Surgery, Ajou University School of Medicine, San 5 Wonchon-dong, Youngtong-gu, Kyounggi-do, Suwon, Korea aut European Spine Journal Springer-Verlag 20/10(2011-10-01), 1635-1643 0940-6719 20:10<1635 2011 20 586 https://doi.org/10.1007/s00586-011-1892-5 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s00586-011-1892-5 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Kim Moon-Chan Department of Orthopaedic Surgery, Bumin Hospital, Busan, Korea aut NATIONALLICENCE 700 1- Chung Hung-Tae Department of Orthopaedic Surgery, Bumin Hospital, Busan, Korea aut NATIONALLICENCE 700 1- Cho Jae-Lim Department of Orthopaedic Surgery, Bumin Hospital, Busan, Korea aut NATIONALLICENCE 700 1- Kim Dong-Jun Department of Orthopaedic Surgery, Bumin Hospital, Busan, Korea aut NATIONALLICENCE 700 1- Chung Nam-Su Department of Orthopaedic Surgery, Ajou University School of Medicine, San 5 Wonchon-dong, Youngtong-gu, Kyounggi-do, Suwon, Korea aut NATIONALLICENCE 773 0- European Spine Journal Springer-Verlag 20/10(2011-10-01), 1635-1643 0940-6719 20:10<1635 2011 20 586 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer