M. Dvorak et al., AN ANATOMIC, RADIOGRAPHIC, AND BIOMECHANICAL ASSESSMENT OF EXTRAPEDICULAR SCREW FIXATION IN THE THORACIC SPINE, Spine (Philadelphia, Pa. 1976), 18(12), 1993, pp. 1689-1694
This study performed a thorough review of the pertinent thoracic spine
anatomy to determine the appropriate landmarks for extrapedicular scr
ew placement and indentified the anatomic structures at risk; assessed
the safety and accuracy of the newly proposed screw insertion techniq
ue; determined the stability and strength of this new screw position t
hrough biomechanical testing; and analyzed the stability of this extra
pedicular screw location with respect to bone mineral density of the v
ertebra.