Pocket Atlas of Spine Surgery by Singh Kern Vaccaro Alexander R

Author:Singh, Kern,Vaccaro, Alexander R.
Language: eng
Format: epub
Publisher: Thieme Medical Publishing Inc.
Published: 2017-12-08T16:00:00+00:00

• Biplanar fluoroscopy is used throughout the procedure.

Superficial landmarks include:

• Thoracic spinous processes:

– Fluoroscopic confirmation of the affected level is required.

• The starting position for the cannula should be at the 10 o’clock or 2 o’clock position of the pedicle (superior-lateral corner depending on the left or right side of the spine). This position places the cannula the farthest from the exiting nerve root. The cannula is advanced such that on the AP side it never crosses the medial edge of the pedicle until it crosses the posterior vertebral body line on the lateral image.

Potential Pitfalls

Fluoroscopic visualization can be hindered by disease processes such as osteoporosis. Position of the C-arms may require adjustment to obtain adequate images in those cases.

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