ABSTRACT
International recommendations in spine surgery require reproducible, safe and effective procedures. The placement of pedicle screws is technically demanding and relies on different methods of support, which result a high rate of complications related to suboptimal screw placement, with reports ranging from 15.7% to 40% according to Hansen-Algenstaedt N and Koktekir E in separate studies. This study carried out a systematic review of existing literature to identify the level of evidence of the placement of pedicle screws outside the pedicle in thoracic and lumbar spine. For the systematic review, a search of the existing literature, based on the use of MeSH terms in PubMed-Medline, Ovid, The Cochrane Library, MedicLatina, Elsevier, and EBSCO databases. According to the literature found, most authors agree that the placement of screws outside the pedicle itself does not represent a serious complication or that requires repositioning in a second surgery even when they are found to have a violation up to 50% of the medial wall of the pedicle. However, they agree that repositioning should be immediate if it is shown with imaging studies such as MRI and CT that endangers vascular and/or neurological structures, or are associated with biomechanical alterations of the spine. Level of Evidence II; Systematic Review of studies level II.
Keywords:
Pedicle Screw; Spinal Cord; Spine
