Improved Accuracy of Minimally Invasive Transpedicular Screw Placement in the Lumbar Spine With 3-Dimensional Stereotactic Image Guidance

Bourgeois, Austin C.; Faulkner, Austin R.; Bradley, Yong C.; Pasciak, Alexander S.; Barlow, Patrick B.; Reid, W. S.

doi:10.1097/bsd.0000000000000152

Cited by 64 publications

(30 citation statements)

References 32 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In our study, all percutaneous pedicle screws were inserted with the assistance of conventional fluoroscopy, and fortunately, there was no malposition of pedicle screws in the two groups. Despite that, we also recommended the use of navigation systems, which could increase the accuracy of percutaneous pedicle screw instrumentation and reduce the fluoroscopic time [32,33].…”

Section: Discussionmentioning

confidence: 99%

Effect of the percutaneous pedicle screw fixation at the fractured vertebra on the treatment of thoracolumbar fractures

Zhong

Ren

et al. 2016

International Orthopaedics (SICOT)

View full text Add to dashboard Cite

show abstract

Section: Discussionmentioning

confidence: 99%

Effect of the percutaneous pedicle screw fixation at the fractured vertebra on the treatment of thoracolumbar fractures

Zhong

Ren

et al. 2016

International Orthopaedics (SICOT)

View full text Add to dashboard Cite

show abstract

“…22 Instrumentation guidance remains the primary application for CAN by most spinal surgeons, with multiple systematic reviews and meta-analyses reporting on the radiographic accuracy of pedicle screws in the cervical, thoracic, and lumbosacral spine, and in multiple clinical contexts including minimally invasive (MIS) percutaneous instrumentation as well as in adolescent idiopathic scoliosis patients. [23][24][25][26][27][28][29][30][31][32] CAN has been proven to reduce radiographic pedicle screw breach rates to under 10% in the cervical spine, under 7% in the thoracic spine, and under 5% in the lumbar spine. 27 Contemporary spinal CAN systems register predominantly to either preoperative CT imaging or intraoperative conebeam CT (CBCT) images acquired via isocentric threedimensional (3-D) fluoroscopy or 360-deg CBCT scanning.…”

Section: Current Paradigm and Challengesmentioning

confidence: 99%

Perspective review on applications of optics in spinal surgery

Guha

Yang

2018

J. Biomed. Opt.

View full text Add to dashboard Cite

Optical technologies may be applied to multiple facets of spinal surgery from diagnostics to intraoperative image guidance to therapeutics. In diagnostics, the current standard remains cross-sectional static imaging. Optical surface scanning tools may have an important role; however, significant work is required to clearly correlate surface metrics to radiographic and clinically relevant spinal anatomy and alignment. In the realm of intraoperative image guidance, optical tracking is widely developed as the current standard of instrument tracking, however remains compromised by line-of-sight issues and more globally cumbersome registration workflows. Surface scanning registration tools are being refined to address concerns over workflow and learning curves, and allow real-time update of tissue deformation; however, the line-of-sight issues plaguing instrument tracking remain to be addressed. In therapeutics, optical applications exist in both visualization, in the form of endoscopes, and ablation, in the form of lasers. Further work is required to extend the feasibility of laser ablation to multiple tissues, including disc, bone, and tumor, in a safe and time-efficient manner. Finally, we postulate some of the short- and long-term opportunities for future growth of optical techniques in the context of spinal surgery. Particular emphasis is placed on intraoperative image guidance, the area of the authors' primary expertise.

show abstract

“…MIS TLIF offers patients a safe and effective surgical treatment option to treat degenerative lumbar spine disease [3]. With navigation guidance, 3-dimensional stereotactic navigation based upon intraoperative computed tomography imaging offers remarkable enhanced accuracy of percutaneous lumbar pedicle screw placement when used in MISTLIF [4]. An additional incision on posterior superior iliac spine (PSIS) remained a recommended setting of dynamic reference frame (DRF) in MISTLIF [5], despite a sustained source of streak artifact.…”

Section: Introductionmentioning

confidence: 99%

Is bony attachment necessary for dynamic reference frame in navigation-assisted minimally invasive lumbar spine fusion surgery?

Lin

Chou

et al. 2019

Computer Assisted Surgery

View full text Add to dashboard Cite

This study aimed to compare the accuracy of navigation-assisted percutaneous pedicle screw insertions between traditional posterior superior iliac spine (PSIS) fixed and cutaneously fixed dynamic reference frame (DRF) in minimally invasive surgery of transforaminal lumbar interbody fusion (MIS TLIF). This is a prospective randomized clinical study. Between May 2016 and Nov 2017, 100 patients who underwent MIS TLIF were randomly divided into bone fixed group (with PSIS fixed DRF) and skin fixed group (with cutaneously fixed DRF). The pedicel screws were inserted under navigational guidance using computed tomography (CT) data acquired intraoperatively with a Ziehm 3-dimensional fluoroscopy-based navigation system. Screw positions were immediately checked by a final intraoperative scan. The accuracy of screw placement was evaluated by a sophisticated computed tomography protocol. Both groups had similar patient demographics. Totally Five-hundred Twelve pedicle screws were placed in the lumbar spine. There were 2 moderate (2-4 mm) pedicle perforations in each group. The accuracy showed no significant difference between bone fixed and skin fixed DRF. There were no significant procedure-related complications. The skin fixed DRF provides similar accuracy in pedicle screw insertions with bone fixed DRF using intraoperative 3D image guided navigation in MIS TLIF. Skin fixed DRF not only serves as an alternative method but also saves a separate incision wound for bony attachment.

show abstract

Improved Accuracy of Minimally Invasive Transpedicular Screw Placement in the Lumbar Spine With 3-Dimensional Stereotactic Image Guidance

Abstract: Three-dimensional stereotactic navigation based upon intraoperative computed tomography imaging offers markedly improved accuracy of percutaneous lumbar pedicle screw placement when used in the setting of MISS.

Cited by 64 publications

References 32 publications

Effect of the percutaneous pedicle screw fixation at the fractured vertebra on the treatment of thoracolumbar fractures

Effect of the percutaneous pedicle screw fixation at the fractured vertebra on the treatment of thoracolumbar fractures

Perspective review on applications of optics in spinal surgery

Is bony attachment necessary for dynamic reference frame in navigation-assisted minimally invasive lumbar spine fusion surgery?

Contact Info

Product

Resources

About