CC BY-NC-ND 4.0 · J Neurosci Rural Pract 2021; 12(03): 555-559
DOI: 10.1055/s-0041-1727410
Original Article

Validation of Freehand Cervical Pedicle Screw Placement in Subaxial Spine Using the “Burcev Technique”: A Cadaveric Study

Mantu Jain
1  Department of Orthopedics, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
,
Rabi N. Sahu
2  Department of Neurosurgery, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
,
Manisha R. Gaikwad
3  Department of Anatomy, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
,
Sashikanta Panda
1  Department of Orthopedics, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
,
Amit Tirpude
3  Department of Anatomy, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
,
Nerbadyswari D. Bag
4  Department of Radiodiagnosis, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
› Author Affiliations
Funding None.

Abstract

The present study attempted to validate the “Burcev freehand method” based on anatomical observations in Indian cadavers. The study was conducted on 32 cervical pedicle screws (CPSs) that were placed in four cadavers by the authors according to the “freehand technique,” described by Burcev et al, without the aid of fluoroscopy and the trajectory verified by computed tomography scans. The screws were designated as satisfactory, permissible, or unacceptable. Descriptive variables were represented in number and percentages, continuous variables were represented as mean ± standard deviation (SD). Of the 32 CPSs placed, 24 (75%) exhibited a satisfactory position, 1 (3%) exhibited a permissible position, and 7 (22%) exhibited an unacceptable position. Of the seven CPSs in the unacceptable group, four exhibited a lateral breach and three exhibited a medial breach, whereas the CPS in the permissible group exhibited a medial breach. The overall angle with contralateral lamina in the horizontal plane in terms of mean ± SD was 175.43 ± 2.82, 169.49, and 169.65 ± 6.46 degrees in the satisfactory, permissible, and unacceptable groups, respectively. In the sagittal plane, the screws exhibited an angle of 88.15 ± 3.56 degrees. No breach was observed superiorly or inferiorly. The “Burcev technique” is replicable with similar results in cadavers. Further studies must be conducted in a clinical setting to ensure its safety.



Publication History

Publication Date:
07 May 2021 (online)

© 2021. Association for Helping Neurosurgical Sick People. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/.)

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