Confirmation of accuracy/inaccuracy of lumbar pedicle screw placement using postoperative computed tomography

Arnaout, Mohamed M.; Elsheikh, Magdy; makia, mansour

doi:10.25259/sni_290_2021

Cited by 6 publications

(1 citation statement)

References 8 publications

(8 reference statements)

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“…[ 6 ] The risks of pedicle medial/lateral violation need to be ruled out for proper transpedicular screw fixation which is best confirmed on CT 3D reconstruction. [ 1 ] Here, in 64 patients with thoracic or lumbar fractures undergoing instrumented fusions, we compared the accuracy of utilizing intraoperative lateral fluoroscopy with postoperative CT 3D navigation. [ 8 ]…”

Section: Introductionmentioning

confidence: 99%

Comparison of the accuracy of intraoperative lateral fluoroscopy versus postoperative computed tomography in spinal fusions

Altaf¹,

Rehman²,

Javeed³

et al. 2023

Surgical Neurology International

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Background: This study compared the accuracy of intraoperative lateral fluoroscopic images versus postoperative computed tomography (CT) 3D studies in the treatment of thoracolumbar spinal fusions. Methods: In a tertiary care hospital (study duration 6 months), we compared the use of lateral fluoroscopic images with the postoperative CT scans in 64 patients with thoracic or lumbar fractures undergoing spinal fusions. Results: Out of the 64 patients, 61% were lumbar followed by 39% thoracic fractures. In the lumbar spine, the accuracy of screw placement utilizing lateral fluoroscopy versus postoperative CT 3D was 97.4%, while in thoracic spine, accuracy was reduced to 84.4%. Of the 64 patients, just 4 (6.2%) patients demonstrated lateral pedicle cortex penetration, 1 (1.5%) patient had a medial pedicle cortex breach, while none exhibited anterior vertebral body cortex penetration. Conclusion: This study documented the efficacy of lateral fluoroscopy in intraoperative thoracic and lumbar spinal fixation as confirmed by postoperative CT 3D studies. These findings support the continued use of fluoroscopy rather than CT intraoperatively to lower the risk of radiation exposure to both patients and surgeons.

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Section: Introductionmentioning

confidence: 99%

Comparison of the accuracy of intraoperative lateral fluoroscopy versus postoperative computed tomography in spinal fusions

Altaf¹,

Rehman²,

Javeed³

et al. 2023

Surgical Neurology International

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Pedicle screw path planning for multi‐level vertebral fixation

Zhao,

Zhang,

Zhan

et al. 2024

Medical Physics

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BackgroundFor the spinal internal fixation procedures, connecting rods to the pedicle screws are commonly used in all spinal segments from the cervical to sacral spine. So far, we have only seen single vertebral screw trajectory planning methods in literatures. Joint screw placements in multi‐level vertebrae with the constraint of an ipsilateral connecting rod are not considered.PurposeIn this paper, a screw trajectory planning method that considers screw‐rod joint system with both multi‐level vertebral constraints and individual vertebral safety tolerance are proposed.MethodsThe proposed method addresses three challenging constraints jointly for multi‐level vertebral fixation with pedicle screws. First, a cylindrical screw safe passage model is suggested instead of a unique mathematical optimal trajectory for a single pedicle. Second, the flexible screw cap accessibility model is also included. Third, the connecting rod is modeled to accommodate the spine contour and support the needed gripping capacity. The retrospective clinical data of relative normal shape spines from Beijing Jishuitan hospital were used in the testing. The screw trajectories from the existing methods based on single vertebra and the proposed method based on multi‐level vertebrae optimization are calculated and compared.ResultsThe results showed that the calculated screw placements by the proposed method can achieve 88% success rate without breaking the pedicle cortex and 100% in clinical class A quality (allow less than 2 mm out of the pedicle cortex) compared to 86.1% and 99.1%, respectively, with the existing methods. Expert evaluation showed that the screw path trajectories and the connecting rod calculated by the new method satisfied the clinical implantation requirements.ConclusionsThe new screw planning approach that seeks an overall optimization for multi‐level vertebral fixation is feasible and more advantageous for clinical use than the single vertebral approaches.

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Unilateral pedicle screw fixation with interbody fusion in lumbar degenerative disease

ElSheikh,

Makia,

Yahia

et al. 2024

Interdisciplinary Neurosurgery

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Confirmation of accuracy/inaccuracy of lumbar pedicle screw placement using postoperative computed tomography

Cited by 6 publications

References 8 publications

Comparison of the accuracy of intraoperative lateral fluoroscopy versus postoperative computed tomography in spinal fusions

Comparison of the accuracy of intraoperative lateral fluoroscopy versus postoperative computed tomography in spinal fusions

Pedicle screw path planning for multi‐level vertebral fixation

Unilateral pedicle screw fixation with interbody fusion in lumbar degenerative disease

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