Minimally invasive guidewireless, navigated pedicle screw placement: a technical report and case series

Smith, Brandon W.; Joseph, Jacob R.; Kirsch, Michael J.; Strasser, Mary O.; Smith, Jacob

doi:10.3171/2017.5.focus17200

Cited by 16 publications

(7 citation statements)

References 25 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In such cases, a percutaneous pedicle screw (PPS) is often employed. PPS placement is gradually being adopted for lumbar and thoracic spine surgery and is performed as a minimally invasive spinal fusion (MIST) approach [ 3 , 4 ]. A previous study showed that single-position surgery (SPS) could reduce the mean surgical time by approximately 34 minutes compared with dual-position surgery (DPS) [ 5 ].…”

Section: Introductionmentioning

confidence: 99%

Accuracy of Percutaneous Pedicle Screw Placement after Single-Position versus Dual-Position Insertion for Lateral Interbody Fusion and Pedicle Screw Fixation Using Fluoroscopy

Hiyama¹,

Katoh²,

Sakai³

et al. 2022

Asian Spine J

View full text Add to dashboard Cite

The purpose of this study was to compare the accuracy of percutaneous pedicle screw (PPS) placement between prone and lateral decubitus positions during lateral lumbar interbody fusion (LLIF) and to evaluate the tendency of PPS positioning based on simple computed tomography measurements with patients in the lateral decubitus position. Overview of Literature: There is insufficient information in the literature regarding the accuracy of inserting a PPS using fluoroscopy in patients in the lateral decubitus position. Methods: We included 62 patients who underwent combined LLIF surgery and PPS fixation for degenerative lumbar spondylolisthesis with spinal canal stenosis. We compared the patient demographics and the accuracy of fluoroscopy-guided PPS placement between two groups: patients who remained in the lateral decubitus position for the pedicle screw fixation (single-position surgery [SPS] group) and those who were turned to the prone position (dual-position surgery [DPS] group). Results: There were 40 patients in the DPS group and 22 in the SPS group. Of the 292 PPSs, only 12 were misplaced. In other words, 280/292 screws (95.9%) were placed correctly in the pedicle's cortical shell (grade 0). PPS insertion did not cause neurological, vascular, or visceral injuries in either group. The breach rates for the DPS and SPS groups were 4.1% (grade 1, 5 screws; grade 2, 3 screws; grade 3, 0 screw) and 4.1% (grade 1, 2 screws; grade 2, 2 screws; grade 3, 0 screw), respectively. Although there were no statistically significant differences, the downside PPS had more screw malpositioning than the upside PPS. Conclusions: We found that PPS insertion with the patient in the decubitus position under fluoroscopic guidance might be as safe and reliable a technique as PPS insertion in the prone position, with a misplacement rate similar to that previously published.

show abstract

Section: Introductionmentioning

confidence: 99%

Accuracy of Percutaneous Pedicle Screw Placement after Single-Position versus Dual-Position Insertion for Lateral Interbody Fusion and Pedicle Screw Fixation Using Fluoroscopy

Hiyama¹,

Katoh²,

Sakai³

et al. 2022

Asian Spine J

View full text Add to dashboard Cite

show abstract

“…Moreover, new approaches and techniques are easier thanks to its application. 25 The objective of our study was to present our case series of HGS treated with transdiscal pedicle screws guided with 3D neuronavigation in adult patients with correct spinal balance and study whether image guidance can improve results compared with previous reports.…”

mentioning

confidence: 99%

Image guidance in transdiscal fixation for high-grade spondylolisthesis in adults with correct spinal balance

Delgado-Fernández¹,

Pulido²,

García-Pallero³

et al. 2018

Neurosurgical Focus

View full text Add to dashboard Cite

OBJECTIVESpondylolisthesis is a prevalent spine disease that recent studies estimate could be detected in 9% of the population. High-grade spondylolisthesis (HGS), however, is much less frequent, which makes it difficult to develop a general recommendation for its treatment. Posterior transdiscal fixation was proposed in 1994 for HGS, and the use of spine navigation could make this technique more accessible and reduce the morbidity associated with the procedure. The purpose of this study was to present a case series involving adult patients with HGS and correct spinal alignment who were treated with transdiscal pedicle screw placement guided with neuronavigation and compare the results to those achieved previously without image guidance.METHODSThe authors reviewed all cases in which adult patients with correct spinal alignment were treated for HGS with posterior transdiscal instrumentation placement guided with navigation between 2014 and 2016 at their institution. The authors compared preoperative and postoperative spinopelvic parameters on standing radiographs as well as Oswestry Disability Index (ODI) scores and visual analog scale (VAS) scores for low-back pain. Follow-up CT and MRI studies and postoperative radiographs were evaluated to identify any screw malplacement or instrumentation failure. Any other intraoperative or postoperative complications were also recorded.RESULTSEight patients underwent posterior transdiscal navigated instrumentation placement during this period, with a mean duration of follow-up of 16 months (range 9–24 months). Six of the patients presented with Meyerding grade III spondylolisthesis and 2 with Meyerding grade IV. In 5 cases, L4–S1 instrumentation was placed, while in the other 3 cases, surgery consisted of transdiscal L5–S1 fixation. There was no significant difference between preoperative and postoperative spinopelvic parameters. However, there was a statistically significant improvement in the mean VAS score for low-back pain (6.5 ± 1.5 vs 4 ± 1.7) and the mean ODI score (49.2 ± 19.4 vs 37.7 ± 22) (p = 0.01 and p = 0.012, respectively). Six patients reduced their use of pain medication. There were no intraoperative or postoperative complications during the hospital stay, and as of the most recent follow-up, no complications related to pseudarthrosis or hardware failure had been observed.CONCLUSIONSTreatment with posterior transdiscal pedicle screws with in situ fusion achieved good clinical and radiological outcomes in patients with HGS and good sagittal spinal balance. The use of navigation and image guidance was associated with improved results in this technique, including a reduction in postoperative and intraoperative complications related to screw malplacement, pseudarthrosis, and instrumentation failure.

show abstract

“…In the traditional method, the accurate percutaneous pedicle screw placement relies heavily on fluoroscopy in order to obtain a proper screw trajectory. The insertion of guide-wire into the vertebral pedicle required numerous radiographic images in a trial-and-error fashion [23]. In recent years, a lot of systems or equipment [11,24,25] were introduced to facilitate the placement of percutaneous pedicle screw.…”

Section: Resultsmentioning

confidence: 99%

A novel retractor for reducing operation time and radiation exposure in percutaneous pedicle screw placement

Niu¹,

He²,

Duan³

et al. 2020

Turkish Neurosurgery

View full text Add to dashboard Cite

Background : Percutaneous pedicle screw fixation is less damage to the surrounding musculature and can decrease both blood loss and recovery time, but depends heavily on fluoroscopic guidance. An efficient instrument or system that allows for accurate pedicle screw placement and reduction in the fluoroscopy shot time would therefore be of value. Methods: 126 patients with single segment thoracolumbar vertebral fracture were surgically treated with percutaneous pedicle screws through our novel retractor technique group A or traditional fluoroscopic method(group B), the operation time and fluoroscopy shot times were compared, and the accuracy of screw placement were assessed. Results : There was no serious complications occurring during our study, such as infection, blood vessel injury, spinal cord or nerve root injury. We did not find any statistically difference between the two groups in corrected rate of regional Cobb's angle or vertebral body height percentage(P>0.05); however, the mean operation time was found to be 75.9±2.37min in the novel retractor method group and 94.2±2.19min in the traditional method group. The difference was statistically significant (p 0.001). Fluoroscopy shot times averaged 9.01±0.41 in the novel retractor group versus 16.8±0.56 in the traditional group (P < 0.001), the novel retractor group had apparent advantages over the traditional method in postoperative improvement on visual analog scale (VAS) scores and Oswestry Disability Index (ODI) at 2days, 3month after operation and last follow-up (P<0.05). There was no statistical difference between the novel retractor group and traditional method group in the radiographic results and screw position violation grade. Conclusion: The novel retractor method had several advantages, including shorter operation time, less fluoroscopy shot times, and better postoperative improvement on visual analog scale(VAS) score and Oswestry Disability Index (ODI). It provides a new alternative method for effective management of thoracolumbar fractures. Background: Percutaneous pedicle screw fixation offer a less traumatic approach resulting in less damage to the surrounding musculature and a decrease in both blood loss and recovery time[1-5]. These

show abstract

Minimally invasive guidewireless, navigated pedicle screw placement: a technical report and case series

Cited by 16 publications

References 25 publications

Accuracy of Percutaneous Pedicle Screw Placement after Single-Position versus Dual-Position Insertion for Lateral Interbody Fusion and Pedicle Screw Fixation Using Fluoroscopy

Accuracy of Percutaneous Pedicle Screw Placement after Single-Position versus Dual-Position Insertion for Lateral Interbody Fusion and Pedicle Screw Fixation Using Fluoroscopy

Image guidance in transdiscal fixation for high-grade spondylolisthesis in adults with correct spinal balance

A novel retractor for reducing operation time and radiation exposure in percutaneous pedicle screw placement

Contact Info

Product

Resources

About