You will prepare the thoracic and lumbar vertebrae for pedicle screw insertion using a variety of tools such as the rongeur, pedicle awl and pedicle probe. The prepared pedicle channel’s integrity will then be checked with a pedicle feeler, before finally inserting the pedicle screws for each vertebrae. Throughout the procedure you can use the image intensifier to check the progress of the channel and be sure you are not breaching the pedicle walls. The key learning is focused on the specific sagittal and transverse angles and screw depths required for each pedicle channel along the spine.
You will learn how to:
- Determine the correct pedicle entry point for each thoracic and lumbar vertebrae.
- Use the pedicle awl to develop the entry point for the pedicle channel.
- Develop the pedicle channel at the correct angles and depths (unique for each vertebrae) using the pedicle probe and feeling how much pressure to apply to develop the channel through the cancellous bone.
- Use the pedicle feeler to check each channel’s integrity by feeling for any breaches of the channel wall.
- Understand how the image intensifier is used to check the channel’s development, ensuring the wall has not been breached and the channel is the correct depth.
- Insert the pedicle screw using the pedicle screwdriver for each thoracic and lumbar vertebrae.
You will be assessed on:
- Knowledge of the correct entry point on the superior spinous process of each thoracic and lumbar vertebrae.
- Ability to use the pedicle awl to penetrate the cortical bone of each vertebrae.
- Accuracy of the sagittal and transverse angles used to develop the channel for each vertebrae.
- Accuracy of the developed channel’s depth for each vertebrae.
- Skills to physically feel the developed channel’s walls to check for any breaches.
- Ability to use and understand the image intensifier to check progress in developing the pedicle channel.