Spinal Pedicle Screw

OVERVIEW

Prior to performing surgery, you can undertake a preoperative educational module reinforcing key surgical anatomy and providing a basic foundation for essential pre- and postoperative procedural knowledge.

During the surgical simulation, 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 depth and integrity of the pedicle channel is then checked with a pedicle feeler before pedicle screw insertion. 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. Before each key surgical objective, knowledge of key anatomy and procedural awareness are assessed.

The key learning is focused on the specific sagittal and transverse angles and screw depths required for each pedicle channel along the spine.

LEARNING OBJECTIVES

You will learn how to:

  • Demonstrate the use of the correct angle for the initiation of a pedicle channel
  • Demonstrate the development of the pedicle channel at the correct angle and to a safe depth
  • Interpret antero-posterior and lateral plain X-ray imaging to check the integrity and depth of pedicle channel and the correct placement of pedicle screws
  • Apply knowledge of the basic surgical objectives and steps for pedicle screw placement
  • Recognise and use key surgical instruments and tools and understand their utility within the procedure
  • Identify the anatomical structures of each vertebra to determine the correct entry point.
  • Demonstrate an appropriate combination of procedural accuracy and application of force throughout the procedure
  • Determine the correct pedicle entry point for each thoracic and lumbar vertebrae.
  • Use the pedicle feeler to check each channel’s integrity by feeling for any breaches of the channel wall.

ASSESSMENT

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.
Pre-Operative Education Narrative
Spinal Simulation
Post Operative Assessment

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