Percutaneous Lumbar Pedicle Screw Placement Aided by Computer-Assisted Fluoroscopy-Based Navigation

Yang, Benson P.; Wahl, Melvin M.; Idler, Cary

doi:10.1097/brs.0b013e31825c05cd

Cited by 78 publications

(27 citation statements)

References 32 publications

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“…As vertebral stability is mainly involved in the anterior middle spine (accounting for ∼60%), performing posterolateral fusion during surgery is not reliable and is ineffective for the stabilization of the anterior middle spine. Bone transplantation of the affected vertebral body is controversial and not all vertebral fractures require bone transplantation (21,22). Bone transplantation of the affected vertebral body is recommended for thoracolumbar unstable fractures, including vertebral fractures with compression >1/3, vertebral burst fractures, fracture fragment intrusion into the spinal canal and cases of a larger empty cavity in the vertebral body following vertebral body reduction and in which long-term vertebral height loss is easily generated (23–26).…”

Section: Discussionmentioning

confidence: 99%

Posterior internal fixation plus vertebral bone implantation under navigational aid for thoracolumbar fracture treatment

Zhou

Kong

Zhao

et al. 2013

Experimental and Therapeutic Medicine

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The aim of this study was to investigate the method of posterior thoracolumbar vertebral pedicle screw reduction and fixation combined with vertebral bone implantation via the affected vertebral body under navigational aid for the treatment of thoracolumbar fractures. The efficacy of the procedure was also measured. Between June 2005 and March 2011, posterior thoracolumbar vertebral pedicle screw reduction and fixation plus artificial bone implantation via the affected vertebral pedicle under navigational aid was used to treat 30 patients with thoracolumbar fractures, including 18 males and 12 females, ranging in age from 21 to 57 years. Compared with the values prior to surgery, intraspinal occupation, vertebral height ratio and Cobb angle at the follow-up were significantly improved. At the long-term follow-up, the postoperative Cobb angle loss was <1° and the anterior vertebral body height loss was <2 mm. Posterior thoracolumbar vertebral pedicle screw reduction and fixation combined with vertebral bone implantation via the affected vertebral body under navigational aid may increase the accuracy and safety of surgery, and it is an ideal method of internal implantation. Bone implantation via the affected vertebral body may increase vertebral stability.

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Section: Discussionmentioning

confidence: 99%

Posterior internal fixation plus vertebral bone implantation under navigational aid for thoracolumbar fracture treatment

Zhou

Kong

Zhao

et al. 2013

Experimental and Therapeutic Medicine

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show abstract

“…The instrumented segments above and below the osteotomy do not require a specific fusion procedure since they are already fused and no additional segment is included into the procedure. Because of the critical anatomy with hypoplastic pedicles, and to reduce radiation exposure, the pedicle screw placement is performed using a navigation system [15]. Protection of neural structures and avoidance of neurological deficits during minimally invasive surgery is improved by using intraoperative navigation in conjunction with neuromonitoring [20].…”

Section: Discussionmentioning

confidence: 99%

“…The use of computer assisted fluoroscopy based surgery helps to reduce this radiation exposure and simultaneously might contribute to lower misplacement rates of percutaneously inserted pedicle screws [14,15].…”

Section: Introductionmentioning

confidence: 99%

Percutaneous three column osteotomy for kyphotic deformity correction in congenital kyphosis

et al. 2013

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“…Although pedicle screw placement with limited touch by hand can reduce the need for fluoroscopy, it can prolong the operative time, and it is difficult to ensure the consistency of the screw entry point and direction, which is not conducive to facilitating fracture reduction. Computer navigation can improve the accuracy of PPS placement, but the high learning curve and high cost limit its application.…”

Section: Introductionmentioning

confidence: 99%

Percutaneous Pedicle Screw Placement Aided by a New Drill Guide Template Combined with Fluoroscopy: An Accuracy Study

Deng

et al. 2020

Orthopaedic Surgery

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Objective: To evaluate the accuracy of percutaneous pedicle screw (PPS) placement aided by a new drill guide template.Methods: The patients were divided into guide template group and conventional perspective group. In the conventional perspective group, the screws were placed by hand under fluoroscopy. In the guide template group, the screw placement was aided by a new drill guide template, and the drill guide template is designed according to the patient's ideal pedicle screw, but not based on skin morphology. The accuracy was evaluated by comparing the following parameters between the two groups: pedicle breach level, inclination angle deviation between the left and right screws, sagittal angle deviation between the left and right screws, and position deviation of the left and right screw entry points. The consistency of the postoperative screw angle and the corresponding guide template inclination angle was compared in the guide template group. The operative time, blood loss, and radiation times were compared between the groups.Results: A total of 146 patients (876 screws) were enrolled in our study including 79 (474 screws) in the guide template group and 67 (402 screws) in the conventional perspective group. The pedicle breach level in the guide template group (22/474) was significantly lower than that in the conventional perspective group (47/402) (P < 0.05). The position and direction deviations of the left and right screws in the guide template group (2.06 AE 1.02 mm, 1.23 AE 1.25 mm, 1.83 AE 1.49 ) were significantly less than those in the conventional perspective group (5.33 AE 2.99 mm, 4.32 AE 3.25 mm, 2.87 AE 1.56 ). The operation time, blood loss, and radiation times were significantly lower in the guide template group (80.49 AE 9.14 min, 50.42 AE 8.9 mL, 11.02 AE 2.44) than those in the conventional perspective group (108.1 AE 21.18 min, 71.7 AE 17.09 mL, 23.53 AE 4.54). There were no significant differences between the postoperative screw angle and the corresponding guide template angle in the guide template group.Conclusion: PPS placement aided by a new drill guide template yielded higher screw accuracy and less operative time, blood loss, and radiation exposure than traditional screw placement.

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Percutaneous Lumbar Pedicle Screw Placement Aided by Computer-Assisted Fluoroscopy-Based Navigation

Abstract: Use of Guidance reduces fluoroscopy and insertion times with increased accuracy compared with conventional fluoroscopic methods of percutaneous pedicle screw insertion.

Cited by 78 publications

References 32 publications

Posterior internal fixation plus vertebral bone implantation under navigational aid for thoracolumbar fracture treatment

Posterior internal fixation plus vertebral bone implantation under navigational aid for thoracolumbar fracture treatment

Percutaneous three column osteotomy for kyphotic deformity correction in congenital kyphosis

Percutaneous Pedicle Screw Placement Aided by a New Drill Guide Template Combined with Fluoroscopy: An Accuracy Study

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