Ideas and technical innovation: a guide for the aligned perforation of vertebral pedicles.

Abstract

This report presents a guide for aligned perforation of vertebral pedicles. In multi-segment fixation of the spine there are technical problems with the placement of aligned pedicular screws when using rods of a wider diameter. To overcome this problem, a device has been developed to aid the placement of aligned pedicular implants along the longitudinal axis of the spine. The device consists of a track along which flat metal tabs containing orifices slide in both directions. The proximal and distal pedicles are first perforated by the standard technique and Kirschner or Steinman wires are passed through the tabs, fixing the device. The next step is the placement of the tabs in an appropriate position for the perforation of the remaining pedicles. These perforations can be made with drills or probes, according to the preference of the surgeon. After perforation, the Kirschner or Steinman wire is introduced in order to help fixate the device. This procedure is repeated until all pedicles have been perforated. The final steps involve the removal of the wires and of the device, and placement of the pedicular screws.