example of patient positioned in prone or lateral decubitus position for percutaneous pedicle screw placement
  • Patient positioning can be either prone or lateral decubitus. 
  • A patient may be in the lateral decubitus position from a lateral lumber interbody fusion procedure and it may be desired to insert Screws and Rods as supplemental fixation without repositioning the patient.

Warning: The lateral decubitus position is not intended for cement augmented procedures with fenestrated screws. 

Precautions: It is recommended to use a Jackson Table to assist in achieving the proper patient positioning and an unrestricted fluoroscopic view. Confirm the C-Arm will allow for easy rotation in the lateral, oblique, and A/P positions around the table. Tables that prohibit unobstructed A/P and lateral images should not be used for this procedure.

patient lying under c-arm for fluoroscopic planning
  • Use A/P and lateral fluoroscopy to identify and target the appropriate level(s). (Fig 2)
  • Ensure that the C-Arm is positioned correctly for each targeted level by adjusting the position of the C-Arm until both endplates are parallel and the spinous process is equidistant from the center of each pedicle when viewed on A-P fluoroscopy. The C-Arm may need to be repositioned for each appropriate level.

 

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