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Review
. 2019 Aug 21:25:6281-6290.
doi: 10.12659/MSM.918061.

Progress of the Anterior Transpedicular Screw in Lower Cervical Spine: A Review

Yuan-Wei Zhang  1   2 , Ting Zeng  2 , Wen-Cheng Gao  3 , Xin Xiao  2 , Yan Xiao  2 , Xi Chen  2 , Su-Li Zhang  4 , Liang Deng  1
Affiliations
Review

Progress of the Anterior Transpedicular Screw in Lower Cervical Spine: A Review

Yuan-Wei Zhang et al. Med Sci Monit. .

Abstract

The anterior transpedicular screws (ATPS) fixation is a valuable discovery in the field of lower cervical spine (LCS) reconstruction, as it has the advantages of both anterior and posterior approaches. In recent years, with in-depth research on ATPS fixation related to anatomy, biomechanical tests, and clinical applications, its firm stability and excellent biomechanical properties have been recognized by more and more surgeons. Although ATPS fixation has been gradually applied in clinic settings under the promotion of emerging distinctive instruments, its long-term efficacy still needs to be further clarified due to the lack of large sample size studies and long-term follow-up. Nevertheless, it is believed that with the maturity of digital devices and the development of precision medicine, ATPS fixation has a promising prospect.

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Conflict of interest statement

Conflict of interests

None.

Figures

Figure 1
Figure 1
Anatomical illustrations of ATPS fixation. (A) Coronal view of lower cervical spine pedicle. (B) Sagittal view of lower cervical spine pedicle. (C) Coronal view of ATPS fixation. (D) Sagittal view of ATPS fixation. ATPS – anterior transpedicular screws; OPW – out pedicle width; PAL – pedicle axis length; tPA – transverse pedicle angle; OPH – Out pedicle height; sPA – sagittal pedicle angle.
Figure 2
Figure 2
The distinctive instruments for ATPS fixation. (A) Designed by Zhao et al. [26]. (B) Designed by Zhang et al. [11]. (C) Designed by Wu et al. [27]. (D) Designed by Zhang et al. [28]. ATPS – anterior transpedicular screws.
Figure 3
Figure 3
Clinical application case with intraoperative and postoperative radiographs. (A) Intraoperative C-arm x-ray showed the direction of K-wire was accurate. (B) C-arm x-ray showed the satisfactory insertion of pedicle screws, titanium mesh and plate. (C, D) Postoperative cervical spine x-rays showed suitable internal fixation position (C: anterior view, D: lateral view). (E) Postoperative transverse computed tomography (CT) showed that insertion of pedicle screws was safe and accurate. (F) Postoperative sagittal CT showed that insertion of pedicle screws was stable and reliable.
See this image and copyright information in PMC

References

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