3D model-assisted instrumentation of the pediatric spine: a technical note

Posterior Instrumentation of Cervical Spine: A Bibliometric Analysis of Trends in Publication

Aim  The aim of this study was to perform a bibliometric analysis of the articles published on posterior instrumentation of cervical spine and to study the general publishing trends over the years in this topic in terms of journals, authors, topics, keywords, collaborating countries, etc. Material and Methods  Articles were searched on the web of science using appropriate keywords. A bibliometric analysis was performed using Bibliometrix R package Results  A total of 1,953 studies were identified between 1991 and 2023 including 1,782 articles and 171 reviews from 198 sources. A total of 3,421 author's keywords were used by 6,725 authors. Thirty-four documents are single authored. The average co-author per document is 5.63. The average citation per document is 22.62. There is international co-authorship in 13.11% documents. RM Xu and Sonntag VKH have maximum publications ( n  = 28). The "Spine" journal has the maximum number of publications ( n  = 335) and best H index of 64. United States has maximum number of publications ( n  = 1,720) and citations ( n  = 19,573). Publication by Harms et al in the "Spine" in 2001 has the highest global ( n  = 956) & local ( n  = 272) citations. Three-dimensional printing and atlantoaxial fixation are emerging trends. Conclusion  The findings of this study enhance the knowledge on the topic of posterior instrumentation of cervical spine and shall guide the trends and directions of future research and innovation.

A novel radiographic analysis system for subaxial cervical spine pedicle screw placement

BACKGROUND

Precise pedicle screw placement of the subaxial cervical spine is difficult. Not every hospital is equipped with a guidance system that can provide effective help. Computed tomography (CT) scanning is almost a routine preoperative examination for cervical spine surgery in all hospitals. Appropriate measurement and analysis of the CT images could assist optimal cervical pedicle screw placement. The purpose of this study is to propose a new and universal method using computed tomography (CT) morphological parameters analysis to assist optimal cervical pedicle screw placement from C3 to C7.

METHODS

A localization system with six parameters was designed based on preoperative CT reconstruction to guide subaxial cervical spine pedicle screw placement. The six parameters were distance from the starting point to the midline [D1], distance from the starting point to the lower edge of the inferior articular process [D2], transverse section angle [TSA], sagittal section angle [SSA], pedicle width [PW], and pedicle height [PH]. The six parameters were analyzed in 53 participants.

RESULTS

Combining D1 and D2 could localize the entrance of the pedicle screw, and we concluded that D1 and TSA and D2 and SSA could be a new standard for determination of the transverse and sagittal orientation of the pedicle screw. The six parameters were closely related to the patient's gender, height, and weight. PH and PW were linearly correlated and could guide selection of the appropriate pedicle screw. SSA was an independent parameter of the relevant vertebral body, and changes in SSA had nothing to do with the curvature or posture of the cervical spine.

CONCLUSIONS

Understanding and applying the six-parameter localization system are essential for achieving accurate and optimal pedicle screw placement in subaxial cervical spine, regardless of cervical sagittal alignment.