Depth of intraspinal wire penetration during passage of sublaminar wires.

A major concern with the use of sublaminar wires for segmental spinal instrumentation is the risk of neurologic compromise associated with repeated passage of wires through the epidural space. Because of the inability to visualize the wire tip during its sublaminar passage, the surgeon is unable to appreciate the depth of wire penetration (DOWP). The purpose of this investigation was to determine, through direct measurement, the depth of intraspinal penetration during the passage of sublaminar wires. Using their model, the authors have been able to define the optimal parameters for safe wire passage. Careful attention to maintaining contact between the wire tip and the under-surface of the lamina, using a wire of optimal configuration, will result in minimal DOWP and reduce the possibility of neurologic compromise.