Accuracy and perforation rate of free-hand pedicle screw insertion in thoracic spine

Abstract Background To assess the accuracy and perforation rate of free-hand pedicle screw insertion in thoracic spine, patients aged 15–70 years with dorsal vertebrae pathology with or without neurological deficit undergoing dorsal spine pedicle screw fixation using free-hand technique were include...

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Main Authors: Mohit Bansal, Cheemullu Shivashankar Shreyas, Mahendra Singh Tak, Mahesh Bhati
Format: Article
Language:English
Published: SpringerOpen 2025-08-01
Series:Egyptian Journal of Neurosurgery
Subjects:
Online Access:https://doi.org/10.1186/s41984-025-00457-y
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author Mohit Bansal
Cheemullu Shivashankar Shreyas
Mahendra Singh Tak
Mahesh Bhati
author_facet Mohit Bansal
Cheemullu Shivashankar Shreyas
Mahendra Singh Tak
Mahesh Bhati
author_sort Mohit Bansal
collection DOAJ
description Abstract Background To assess the accuracy and perforation rate of free-hand pedicle screw insertion in thoracic spine, patients aged 15–70 years with dorsal vertebrae pathology with or without neurological deficit undergoing dorsal spine pedicle screw fixation using free-hand technique were included. Revision surgery and patients who needed deformity correction surgery were excluded. The accuracy of pedicle screw placement was assessed by Gertzbein and Robbins classification scores on computed tomography scans. Microsoft Excel and statistical softwares were used for data cleaning and statistical analysis. Categorical and continuous variables were reported in proportions and mean ± standard deviation. A paired sample t-test was used to assess and determine whether there was a mean difference between the two sets of observations. The statistical significance was determined at a 5% level. Results Seventy (36.26%) pedicle screws were inserted for infective pathology, and 91.7% of pedicle screws showed no breach. Thoracic spine 3–7 vertebra demonstrated the highest breach rate (11/16) (68.75%). The direction of the breach was lateral in ten screws (62.5%) and medial in six screws (37.5%), and there was no inferior and superior breached screw. The breach was not statistically significant. Conclusions Free-hand technique has excellent accuracy and insignificant perforation rate in instrumentation of the thoracic spine.
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institution Kabale University
issn 2520-8225
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series Egyptian Journal of Neurosurgery
spelling doaj-art-13d83ccd86264fce8d253ef8461ca1eb2025-08-20T03:42:20ZengSpringerOpenEgyptian Journal of Neurosurgery2520-82252025-08-014011610.1186/s41984-025-00457-yAccuracy and perforation rate of free-hand pedicle screw insertion in thoracic spineMohit Bansal0Cheemullu Shivashankar Shreyas1Mahendra Singh Tak2Mahesh Bhati3Department of Orthopedics, Dr. Sampurnanand Medical CollegeDepartment of Orthopedics, Dr. Sampurnanand Medical CollegeDepartment of Orthopedics, Dr. Sampurnanand Medical CollegeDepartment of Orthopedics, Dr. Sampurnanand Medical CollegeAbstract Background To assess the accuracy and perforation rate of free-hand pedicle screw insertion in thoracic spine, patients aged 15–70 years with dorsal vertebrae pathology with or without neurological deficit undergoing dorsal spine pedicle screw fixation using free-hand technique were included. Revision surgery and patients who needed deformity correction surgery were excluded. The accuracy of pedicle screw placement was assessed by Gertzbein and Robbins classification scores on computed tomography scans. Microsoft Excel and statistical softwares were used for data cleaning and statistical analysis. Categorical and continuous variables were reported in proportions and mean ± standard deviation. A paired sample t-test was used to assess and determine whether there was a mean difference between the two sets of observations. The statistical significance was determined at a 5% level. Results Seventy (36.26%) pedicle screws were inserted for infective pathology, and 91.7% of pedicle screws showed no breach. Thoracic spine 3–7 vertebra demonstrated the highest breach rate (11/16) (68.75%). The direction of the breach was lateral in ten screws (62.5%) and medial in six screws (37.5%), and there was no inferior and superior breached screw. The breach was not statistically significant. Conclusions Free-hand technique has excellent accuracy and insignificant perforation rate in instrumentation of the thoracic spine.https://doi.org/10.1186/s41984-025-00457-yVertebraSpinal columnThoracic spinePedicle
spellingShingle Mohit Bansal
Cheemullu Shivashankar Shreyas
Mahendra Singh Tak
Mahesh Bhati
Accuracy and perforation rate of free-hand pedicle screw insertion in thoracic spine
Egyptian Journal of Neurosurgery
Vertebra
Spinal column
Thoracic spine
Pedicle
title Accuracy and perforation rate of free-hand pedicle screw insertion in thoracic spine
title_full Accuracy and perforation rate of free-hand pedicle screw insertion in thoracic spine
title_fullStr Accuracy and perforation rate of free-hand pedicle screw insertion in thoracic spine
title_full_unstemmed Accuracy and perforation rate of free-hand pedicle screw insertion in thoracic spine
title_short Accuracy and perforation rate of free-hand pedicle screw insertion in thoracic spine
title_sort accuracy and perforation rate of free hand pedicle screw insertion in thoracic spine
topic Vertebra
Spinal column
Thoracic spine
Pedicle
url https://doi.org/10.1186/s41984-025-00457-y
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AT mahendrasinghtak accuracyandperforationrateoffreehandpediclescrewinsertioninthoracicspine
AT maheshbhati accuracyandperforationrateoffreehandpediclescrewinsertioninthoracicspine