A prospective study on the use of intraoperative computed tomography (iCT) for image-guided placement of thoracic pedicle screws

Dinesh, Shree Kumar; Tiruchelvarayan, Rajendra; Ng, Ivan

doi:10.3109/02688697.2012.690917

Cited by 25 publications

(9 citation statements)

References 27 publications

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“…5,6 Examples of these techniques include the use of anatomic landmarks, 7 laminotomy for palpation of the pedicle, plain radiography, fluoroscopic imaging (standard or image guidance), 8,9 and CT image guidance. [10][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27] Extensive literature has been published describing the technique, benefits, and drawbacks of each method, as well as comparisons between different approaches. [28][29][30][31][32][33][34][35][36][37][38][39][40][41][42][43][44][45] With its increasing use has come a multitude of studies regarding the safety of this technique.…”

Section: Introductionmentioning

confidence: 99%

Reliability of the Planned Pedicle Screw Trajectory versus the Actual Pedicle Screw Trajectory using Intra-operative 3D CT and Image Guidance

et al. 2016

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Section: Introductionmentioning

confidence: 99%

Reliability of the Planned Pedicle Screw Trajectory versus the Actual Pedicle Screw Trajectory using Intra-operative 3D CT and Image Guidance

et al. 2016

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“…The variability can also be explained by the free-hand method's reliance on surgeon technique preferences, not producing easily reproducible parameters for other surgeons 1 . In contrast to the free-hand method, studies illustrating the used of image-guided techniques have reported an accuracy range of 91.5% to 97.7%, overall much higher than the average accuracies reported for the free-hand technique 3,9,15,17,18,22,27 .…”

Section: Discussionmentioning

confidence: 78%

Thoracic, Lumbar, and Sacral Pedicle Screw Placement Using Stryker-Ziehm Virtual Screw Technology and Navigated Stryker Cordless Driver 3: Technical Note

Satarasinghe¹,

Hamilton²,

Tarver³

et al. 2018

Preprint

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Object. Utilization of pedicle screws (PS) for spine stabilization is common in spinal surgery. With reliance on visual inspection of anatomical landmarks prior to screw placement, the free-hand technique requires a high level of surgeon skill and precision. Three-dimensional (3D) computer-assisted virtual neuronavigation improves the precision of PS placement and minimize steps. Methods. Twenty-three patients with degenerative, traumatic, or neoplastic pathologies received treatment via a novel three-step PS technique that utilizes a navigated power driver in combination with virtual screw technology. 1) Following visualization of neuroanatomy using intraoperative CT, a navigated 3-mm match stick drill bit was inserted at anatomical entry point with screen projection showing virtual screw. 2) Navigated Stryker Cordless Driver with appropriate tap was used to access vertebral body through pedicle with screen projection again showing virtual screw. 3) Navigated Stryker Cordless Driver with actual screw was used with screen projection showing the same virtual screw. One hundred and forty-four consecutive screws were inserted using this three-step, navigated driver, virtual screw technique. Results. Only 1 screw needed intraoperative revision after insertion using the three-step, navigated driver, virtual PS technique. This amounts to a 0.69% revision rate. One hundred percent of patients had intraoperative CT reconstructed images to confirm hardware placement. Conclusions. Pedicle screw placement utilizing the Stryker-Ziehm neuronavigation virtual screw technology with a three step, navigated power drill technique is safe and effective.

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“…Free-hand approach studies reported overall accuracies for pedicle screw placement as low as 71.9%; however, the range of accuracy for PS insertion using the free-hand technique has been reported as high as 91.3% [ 3 , 16 , 17 , 18 , 19 , 20 , 21 , 22 ]. The huge variability in accuracy can potentially be attributed to the learning curve required to master the free-hand technique, as the procedure is generally safe for experienced surgeons but results in complications for junior surgeons [ 6 , 9 ].…”

Section: Discussionmentioning

confidence: 99%

Thoracic, Lumbar, and Sacral Pedicle Screw Placement Using Stryker-Ziehm Virtual Screw Technology and Navigated Stryker Cordless Driver 3: Technical Note

Satarasinghe

Hamilton

Tarver

et al. 2018

JCM

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Object. Utilization of pedicle screws (PS) for spine stabilization is common in spinal surgery. With reliance on visual inspection of anatomical landmarks prior to screw placement, the free-hand technique requires a high level of surgeon skill and precision. Three-dimensional (3D), computer-assisted virtual neuronavigation improves the precision of PS placement and minimization steps. Methods. Twenty-three patients with degenerative, traumatic, or neoplastic pathologies received treatment via a novel three-step PS technique that utilizes a navigated power driver in combination with virtual screw technology. (1) Following visualization of neuroanatomy using intraoperative CT, a navigated 3-mm match stick drill bit was inserted at an anatomical entry point with a screen projection showing a virtual screw. (2) A Navigated Stryker Cordless Driver with an appropriate tap was used to access the vertebral body through a pedicle with a screen projection again showing a virtual screw. (3) A Navigated Stryker Cordless Driver with an actual screw was used with a screen projection showing the same virtual screw. One hundred and forty-four consecutive screws were inserted using this three-step, navigated driver, virtual screw technique. Results. Only 1 screw needed intraoperative revision after insertion using the three-step, navigated driver, virtual PS technique. This amounts to a 0.69% revision rate. One hundred percent of patients had intraoperative CT reconstructed images taken to confirm hardware placement. Conclusions. Pedicle screw placement utilizing the Stryker-Ziehm neuronavigation virtual screw technology with a three step, navigated power drill technique is safe and effective.

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A prospective study on the use of intraoperative computed tomography (iCT) for image-guided placement of thoracic pedicle screws

Abstract: The iCT based spinal neuronavigation system allowed for highly safe and accurate placement (97.3%) of thoracic pedicle screws in our institution with no neurovascular injury reported.

Cited by 25 publications

References 27 publications

Reliability of the Planned Pedicle Screw Trajectory versus the Actual Pedicle Screw Trajectory using Intra-operative 3D CT and Image Guidance

Reliability of the Planned Pedicle Screw Trajectory versus the Actual Pedicle Screw Trajectory using Intra-operative 3D CT and Image Guidance

Thoracic, Lumbar, and Sacral Pedicle Screw Placement Using Stryker-Ziehm Virtual Screw Technology and Navigated Stryker Cordless Driver 3: Technical Note

Thoracic, Lumbar, and Sacral Pedicle Screw Placement Using Stryker-Ziehm Virtual Screw Technology and Navigated Stryker Cordless Driver 3: Technical Note

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