Accuracy of a dynamic surgical guidance probe for screw insertion in the cervical spine: a cadaveric study

Dixon, D. A.; Darden, I I Bruce; Casamitjana, J; Weissmann, Karen; Cristóbal, San; Powell, D. L.; Baluch, Daniel A.

doi:10.1007/s00586-016-4840-6

Cited by 7 publications

(4 citation statements)

References 32 publications

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“…Koller et al 17 . and Dixon et al 28 . did preliminary researches on cadavers on cervical and thoracic spine.…”

Section: Discussionmentioning

confidence: 99%

“…Since then, studies carried out to prove the accuracy in different conditions. Koller et al 17 and Dixon et al 28 did preliminary researches on cadavers on cervical and thoracic spine. Williams et al 29 also did a cadaver study and found that the sensitivity to detecting cortical breach was 97% in pedicle drillings and 84% in vertebral body drillings, respectively.…”

Section: Safety and Effectiveness Of The Modified Ecd Withmentioning

confidence: 99%

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Spine Surgery with Electronic Conductivity Device: A Prospectively Multicenter Randomized Clinical Trial and Literature Review

Zhai,

Li,

Chen

et al. 2023

Orthopaedic Surgery

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ObjectiveImproving accuracy and safety of pedicle screw placement is of great clinical importance. Electronic conductivity device (ECD) can be a promising technique with features of affordability, portability, and real‐time detection capabilities. This study aimed to validate the safety and effectiveness of a modified ECD.MethodsThe ECD underwent a modification where six lamps of various colors, and it was utilized in a prospectively multicenter randomized controlled clinical trial involving 96 patients across three hospitals from June 2018 to December 2018. The trial incorporated a self‐control randomization with an equal distribution of left or right side of vertebral pedicle among two groups: the free‐hand group and the ECD group. A total of 496 pedicle screws were inserted, with 248 inserted in each group. The primary outcomes focused on the accuracy of pedicle screw placement and the frequency of intraoperative X‐rays. Meanwhile, the secondary indicator measured the time required for pedicle screw placement. Results were presented as means ± SD. Paired samples t‐test and χ2‐test were used for comparison. Furthermore, an updated review was conducted, which included studies published from 2006 onwards.ResultsBaseline patient characteristics were recorded. The primary accuracy outcome revealed a 96.77% accuracy rate in the ECD group, compared to a 95.16% accuracy rate in the free‐hand group, with no significant differences noted. In contrast, ECD demonstrated a significant reduction in radiation exposure frequency when compared to the free‐hand group (1.11 ± 0.32 vs. 1.30 ± 0.53; p < 0.001), resulting in a 14.6% reduction. Moreover, ECD displayed a decrease of 30.38% in insertion time (70.88 ± 30.51 vs. 101.82 ± 54.00 s; p < 0.001). According to the results of the 21 studies, ECD has been utilized in various areas of the spine such as the atlas, thoracic and lumbar spine, as well as sacral 2‐alar‐iliac. The accuracy of ECD ranged from 85% to 100%.ConclusionThe prospectively randomized trial and the review indicate that the use of ECD presents a secure and precise approach to the placement of pedicle screws, with the added benefit of reducing both procedure time and radiation exposure.

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“…Koller et al 17 . and Dixon et al 28 . did preliminary researches on cadavers on cervical and thoracic spine.…”

Section: Discussionmentioning

confidence: 99%

Section: Safety and Effectiveness Of The Modified Ecd Withmentioning

confidence: 99%

Spine Surgery with Electronic Conductivity Device: A Prospectively Multicenter Randomized Clinical Trial and Literature Review

Zhai,

Li,

Chen

et al. 2023

Orthopaedic Surgery

View full text Add to dashboard Cite

show abstract

“…The instrument was found to be a safe tool that assists the surgeon with screw placement in the cervical spine. Additionally, it potentially avoids the cumulative risks associated with fluoroscopy (radiation exposure) and provides real‐time feedback to the surgeon, thus allowing correction at the time of breach …”

Section: Discussionmentioning

confidence: 99%

Novel electrical conductivity device for osteotomy preparation for dental implants placement: A cadaver study

Lorean

Barer²,

Barbu

et al. 2018

Clin Implant Dent Rel Res

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“…This device uses audio alerts and light-emitting diode warning signals to guide surgeons. According to a limited number of papers [16,[20][21][22][23][24][25][26][27][28], the usefulness of ECD for pedicle proving has been reported during posterior fusion surgery for scoliosis, degenerative disease, and tumors. However, no evidence exists regarding its efficacy even for syndromic and neuromuscular scoliosis in which pedicle screw placement is extremely difficult.…”

Section: Introductionmentioning

confidence: 99%

Improved Accuracy and Safety of Pedicle Screw Placement by Using a Probe with an Electrical Conductivity-Measuring Device during Severe Syndromic and Neuromuscular Scoliosis Spine Surgery

Yurube

Kanda

Ito

et al. 2022

JCM

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An electrical conductivity-measuring device (ECD) has recently been developed to support pedicle screw placement. However, no evidence exists regarding its efficacy for syndromic/neuromuscular scoliosis with extremely difficult screwing. We retrospectively reviewed 2010–2016 medical records of 21 consecutive syndromic/neuromuscular scoliosis patients undergoing free-hand segmental fixation surgery at our institution and compared the pedicle screw insertion accuracy and safety between 10 with a conventional non-ECD probe (2010–2013) and 11 with an ECD probe (2014–2016). We analyzed preoperative pedicle shape and postoperative screw placement in computed tomography. There were no significant differences between ECD and non-ECD groups in demographic, clinical, and treatment characteristics including scoliosis severity and pedicle diameter. The abandonment rate due to liquorrhea or perforation was lower in ECD (12.3%) than in non-ECD (26.7%) (p < 0.01). Acceptable insertion without perforation or <2-mm lateral/cranial position was more frequent in ECD (67.1%) than in non-ECD (56.9%) (p = 0.02). Critical ≥5-mm medial/caudal malposition was not seen in ECD (0.0%) but in non-ECD (2.4%) (p = 0.02). The perforation distance was shorter in ECD (2.2 ± 1.1 mm) than in non-ECD (2.6 ± 1.7 mm) (p = 0.01). Results involve small sample size, selection, performance, and learning curve biases; nevertheless, ECD could be useful for more accurate and safer pedicle screw placement in severe syndromic/neuromuscular scoliosis.

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Accuracy of a dynamic surgical guidance probe for screw insertion in the cervical spine: a cadaveric study

Cited by 7 publications

References 32 publications

Spine Surgery with Electronic Conductivity Device: A Prospectively Multicenter Randomized Clinical Trial and Literature Review

Spine Surgery with Electronic Conductivity Device: A Prospectively Multicenter Randomized Clinical Trial and Literature Review

Novel electrical conductivity device for osteotomy preparation for dental implants placement: A cadaver study

Improved Accuracy and Safety of Pedicle Screw Placement by Using a Probe with an Electrical Conductivity-Measuring Device during Severe Syndromic and Neuromuscular Scoliosis Spine Surgery

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