Risk of vertebral artery injury associated with subaxial cervical pedicle screw malposition: cadaveric evidence and clinical relevance

This study experimentally validated the "safe zone" hypothesis, confirming its presence and effectiveness. In cases of screw breach, the decision for revision surgery should be based on the patient's clinical condition and breach status (vessel displaced or injured), rather than the screw position alone. However, if a vertebral artery injury is suspected, acute intervention should be initiated promptly.