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OBJECTIVE Loosening and pullout of pedicle screws are well-known problems in pedicle screw fixation surgery. Augmentation of pedicle screws with bone cement, first described as early as 1975, increases the pedicle-screw interface and pullout force in osteoporotic vertebrae. The aim of the present study was to identify cement leakage and pulmonary embolism rates in a large prospective single-center series of pedicle screw augmentations. METHODS All patients who underwent cement-augmented pedicle screw placement between May 2006 and October 2010 at the authors' institution were included in this prospective cohort study...

The spectre of wrong-level surgery has many a spinal surgeon double-checking the spinal level at which an operation is being carried out especially in the thoracic spine, in the absence of abnormal-looking vertebrae which could help to identify the intended level. Getting the level wrong is easily done if there is an unusual number of vertebrae or if the direction of the count digresses from the imaging available.