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Stephen I. Esses, M.D.

Since the 1960s, a variety of experimental pedicle screw fixation systems have been implemented in clinical trials in Europe; however, only recently have these systems become popular in North America. This slow rate of acceptance among surgeons can be attributed to two major reasons: concern for possible complications, including injury to neurological and vascular structures from inaccurate placement of instrumentation and relatively high rates of infection in the postoperative period.

In this VJO segment, Dr. Esses discusses the potential pitfalls associated with pedicle screw implants and explains the steps surgeons can take to minimize risks. In a surgical demonstration, Dr. Esses implants a pedicle rod system and elaborates on the proper steps for assuring accurate screw placement in the pedicle.

References
1. Esses SI, Sachs BL, Dreyzin V Complications associated with the technique of pedicle screw fixation Spine 1993;15:2231-2239
2. Crawford MJ, Esses SI Indications for pedicle fixation -- results of NASS/SRS faculty questionnaire Spine 1994;19(22):2584-2589
3. Steffee AD, Biscup RS, Sitkowski DJ Segmental spine plates with pedicle screw fixation: A new internal fixation device for disorders of the lumbar and thoracolumbar spine Clin Orthop 1986;203:45-53

• Total Run Time: 21:20 minutes
• Catalog Number: 8013
• Publication Date: April 1995

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