Fluoroscopy for transpedicular screw placement in scoliosis: to what extent can radiation exposure be reduced by the freehand technique?

Abstract

AIm:In spinal surgery, high doses of radiation are delivered during surgical procedures that require fluoroscopic control. The aim of this study was to determine the amount of radiation delivered from the fluoroscopic unit and also the factors to reduce the amount of radiation during the surgery of adolescent idiopathic scoliosis patients. sOnuÇ: Adolasan idiopatik skolyozlu hastaların cerrahi düzeltmesinde transpediküler vidaların serbest el tekniği ile yerleştirilmesi, AP ve lateral floroskobik görüntüler ile vida pozisyonunun teyidi sırasında birden fazla segmentin görüntülenmesi, anormal pediküler anatominin olduğu segmentlerde K tellerinin klavuz olarak kullanılması ve hastanın nöromoniterizasyonu hastaya ve cerrahi takıma iletilen iyonize radyasyon miktarını azaltabilir.

Comparative Radiation Exposure Using Standard Fluoroscopy Versus Cone-Beam Computed Tomography for Posterior Instrumented Fusion in Adolescent Idiopathic Scoliosis

“…5 , 6 Standard fl uoroscopy can be used for visualization of anatomical landmarks and placement of pedicle screws as well as postplacement confi rmation of screw position. 7 CBCT has been advocated as a method to improve accuracy of pedicle screw placement to avoid Results. Calculated average effective dose using fl uoroscopically assisted pedicle screw placement was 0.189 mSv (range, 0.00029-0.953 mSv; SD = 0.16711) per case.…”

Fluoroscopy for transpedicular screw placement in scoliosis: what is the best method of measuring radiation exposure?

“…We read with interest the article titled "Fluoroscopy for transpedicular screw placement in scoliosis: to what extent can radiation exposure be reduced by the freehand technique?" by Ege et al (1).…”

Tratamiento de deformidad severa de la columna vertebral con modelos de impresión 3D

“…La técnica preferida para la colocación de tornillos transpediculares es la de «manos libres», pues ahorra tiempo quirúrgico y disminuye la radiación al prescindir del brazo fluoroscópico. 8,9 Sin embargo, esta técnica podría no ser óptima cuando se usa en el tratamiento de deformidades estructurales que alteran la topología anatómica normal de la columna, como el caso de la displasia pedicular, en la cual la relación corticomedular del pedículo impide la inserción habitual de los tornillos transpediculares (Figura 2). 1,10 En los casos donde el pedículo presenta grados de displasia pedicular avanzados tipo C y D el cirujano previa planificación quirúrgica puede optar por la inserción yuxtapedicular del pedículo, esto es con una violación intencionada de la cortical lateral para la inserción del tornillo (Figura 3).…”