Ultrasound as a Guide for Intrapedicular Screw Placement**

The 3 dimensional deformity of scoliosis presents difficulties in accurate pedicle screw placement. This is due to the rotational element of the pedicle and vertebral body. We describe a method where a 40 MHz ultrasound probe is used to determine optimal pedicle screw placement. In vivo studies successfully demonstrated an intact cortical bony sleeve in the pedicle prior to accurate screw placement. The ultrasonic probe was also able to identify less optimal pedicle screw tracts in which the cortical bony sleeve was breached. We conclude that ultrasound guidance is helpful in difficult intrapedicular screw placement.

** The FDA has not cleared a drug and/or medical device for the use described in this presentation (i.e., the drug or medical device is being discussed in an “off-label” use).