Pedicle Sight in Spine Surgery: A Raymond Roy-Camille's Innovation

Raymond Roy-Camille (Fort de France 1927-Paris 1994) performed for the first time on 1963 April a spine fixation using transpedicular screws and plates. The first case concerned a 17 years old woman, presenting a L4-L5 dislocation with complete neurological deficiency. A reduction followed by spine fixation using two Sherman plates was performed. On 1970, the transpedicular screwing technique was described in two publications: the penetration point and the “straight forward” direction of the screw were specified. The fixation plates were adapted to the interpedicular space (26mm) and improved (reinforced plates, Domino system). In a first time indicated in traumatic injuries, transpedicular screwing was secondarily used in degenerative pathology (lombarthrosis, spondylolisthesis, spine intability), spine tumors and scoliosis surgery. The diffusion of the technique required a long time, especially in United States and was promoted by many international communications and publications. The transpedicular screwing principle was used in many spine fixation systems (Magerl, Dick, Cotrel-Dubousset). Modifications of the initial technique has been proposed (screwing direction, computer assisted surgery, cervical spine fixation). The transpedicular screwing principle is currently universal. We must keep in mind the potential dangerousness of this technique and the necessity of a strict surgical training.