Published online Apr 18, 2014. doi: 10.5312/wjo.v5.i2.112
Revised: February 11, 2014
Accepted: March 13, 2014
Published online: April 18, 2014
Core tip: Pedicle screws are currently placed in the thoracolumbar spine via three main techniques: free-hand, fluoroscopy guidance, and stereotactic navigation. Various studies have reported success with each of these techniques. However, it is clear that there is some difficulty in comparing such studies due to differing definitions of accuracy and methods of evaluation. Regardless, it is evident that image-assisted techniques provide some benefit when cannulating mid-thoracic vertebral levels and vertebrae that have altered morphology due to deformation from complex pathologies. However, a surgeon’s ultimate decision must be based on individual experience and comfort with a given technique.