This study performed a thorough review of the pertinent thoracic spins anatomy to determine the appropriate landmarks for extrapedicular screw placement and indentified the anatomic structures at risk; assessed the safety and accuracy of the newly proposed screw insertion technique; determined the stability end strength of this new screw position through biomechanical testing; and analyzed the stebility of this extrapedicular screw location with respect to bone mineral density of the vertebra.
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