ABSTRACT
Pedicle screw fixation has been used in the thoracic spine for various clinical indications, including traumatic, deformity, and degenerative conditions. With its biomechanical superiority, pedicle screw fixation has supplanted wiring and hook-based techniques as the preferred method of posterior spinal fixation in the thoracic spine. Percutaneous pedicle screw fixation is a challenging procedure that requires experience and an in-depth understanding of spinal anatomy to perform safely. Placement of percutaneous pedicle screws relies primarily on fluoroscopic guidance to determine the location of the entry point and trajectory through the respective pedicle. Trauma is the most common indication for percutaneous pedicle screw fixation in the thoracic spine. A radiolucent table and modern fluoroscopy are recommended for percutaneous placement of thoracic pedicle screws. Fluoroscopy in the lateral view is used to confirm the level of surgery, and the cephalad–caudal levels of the respective pedicles are marked on the patient’s back with a marking pen.
