Utilization of Spinal Navigation to Facilitate Hassle-Free Rod Placement during Minimally-Invasive Long-Construct Posterior Instrumentation

Kaliya-Perumal, Arun-Kumar; Limthongkul, Worawat; Oh, Jacob Yoong-Leong

doi:10.31616/asj.2018.0233

Cited by 4 publications

(4 citation statements)

References 15 publications

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“…Technological advancements have made spine surgery safer, predictable and precise [ 18 – 20 ]. However, recent advancements such as computer navigation and robotic assistance for placement of pedicle screws come at a cost and are not universally available at present [ 18 ].…”

Section: Discussionmentioning

confidence: 99%

Incidence of pedicle breach following open and minimally invasive spinal instrumentation: A postoperative CT analysis of 513 pedicle screws applied under fluoroscopic guidance

Chong¹,

Kumar²,

Yang³

et al. 2020

BioMedicine

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Background: Even though pedicle screw application is a common procedure, and in-spite of spine surgeons being proficient with the technique, mal-positioning of pedicle screws can still occur. We intend to determine by postoperative CT analysis, the incidence of pedicle screw breach in the thoracolumbar spine despite satisfactory intraoperative placement confirmed by fluoroscopy. Materials and methods: Consecutive patients diagnosed with thoracolumbar fractures who underwent open or minimally invasive posterior stabilization under fluoroscopic guidance were retrospectively reviewed. Postoperative CT scans of patients were analysed to determine the incidence of pedicle breach despite satisfactory intraoperative placement, and also to determine the factors that can predict a breach during intraoperative assessment. Results: A total of 61 patients with 513 thoracolumbar pedicle screws were available for analysis. Based on our postoperative CT assessment, 28 screws (5.5%; 18 thoracic screws; 10 lumbar screws) had breached the pedicle. There were 14 minor (<3 mm) and 14 major (≥3 mm) breaches. The minimally invasive technique had a significantly lower breach rate compared to open surgery (1.9% vs. 7.9%). By retrospectively analysing the intra-operative fluoroscopic images, we determined certain parameters that could predict a breach during surgery. Conclusion: Pedicle breaches can still be present despite satisfactory placement of screws visualized intra-operatively. A medial breach is most likely when the length of the pedicle screw spans only up to 50% of the vertebral body as seen on the lateral view but the pedicle screw tip has already transgressed the midline as seen on an AP view. A lateral breach is likely when the tip of the pedicle screw is overlapped by the screw head or is only minimally visualized on an AP view.

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Section: Discussionmentioning

confidence: 99%

Incidence of pedicle breach following open and minimally invasive spinal instrumentation: A postoperative CT analysis of 513 pedicle screws applied under fluoroscopic guidance

Chong¹,

Kumar²,

Yang³

et al. 2020

BioMedicine

Self Cite

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“…Debilitating consequences for patients can occur due to damage to important structures such as nerves and blood vessels. Navigation systems that use real-time images improve surgical accuracy [ 114 , 115 ]. Using O-arm, a high-quality computed tomography (CT) scan can be performed.…”

Section: Latest Advancesmentioning

confidence: 99%

Evolution, Current Trends, and Latest Advances of Endoscopic Spine Surgery

Gunjotikar,

Pestonji,

Tanaka

et al. 2024

JCM

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Background: The aging of the population in developing and developed countries has led to a significant increase in the health burden of spinal diseases. These elderly patients often have a number of medical comorbidities due to aging. The need for minimally invasive techniques to address spinal disorders in this elderly population group cannot be stressed enough. Minimally invasive spine surgery (MISS) has several proven benefits, such as minimal muscle trauma, minimal bony resection, lesser postoperative pain, decreased infection rate, and shorter hospital stay. Methods: A comprehensive search of the literature was performed using PubMed. Results: Over the past 40 years, constant efforts have been made to develop newer techniques of spine surgery. Endoscopic spine surgery is one such subset of MISS, which has all the benefits of modern MISS. Endoscopic spine surgery was initially limited only to the treatment of lumbar disc herniation. With improvements in optics, endoscopes, endoscopic drills and shavers, and irrigation pumps, there has been a paradigm shift. Endoscopic spine surgery can now be performed with high magnification, thus allowing its application not only to lumbar spinal stenosis but also to spinal fusion surgeries and cervical and thoracic pathology as well. There has been increasing evidence in support of these newer techniques of spine surgery. Conclusions: For this report, we studied the currently available literature and outlined the historical evolution of endoscopic spine surgery, the various endoscopic systems and techniques available, and the current applications of endoscopic techniques as an alternative to traditional spinal surgery.

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“…consequences for patients can occur to damage to important structures such as nerves and blood vessels . Navigation systems that use real-time images improve surgical accuracy [103,104]Using O-arm, a high-quality computed tomography (CT) scan can be performed. Surgeons can perform intraoperative three-dimensional (3D) anatomical mapping in real time by integrating it with a real-time anatomical tracking tool [105].…”

Section: Endoscopic Aterior Cevical Dscectomy and Fusionmentioning

confidence: 99%

Evolution, Current Trends and Latest Advances of Endoscopic Spine Surgery: A Narrative Review

Gunjotikar,

Pestonji,

Tanaka

et al. 2024

Preprint

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The aging of the population in developing and developed countries has lead to a significant increase in health burden of spinal diseases. These elderly patients often have a number of medical co-morbidities due to aging. The need for minimally invasive techniques to address spinal disorders in this elderly population group cannot be stressed enough. Minimally invasive spine surgery (MISS) has several proven benefits such as minimal muscle trauma, minimal bony resection, lesser post-operative pain, decreased infection rate and shorter hospital stay. Over the last 40 years, constant efforts are being made to develop newer techniques of spine surgery. Endoscopic spine surgery is one such subset of MISS which has all the benefits of modern MISS. Endoscopic spine surgery initially was limited only to treatment of lumbar disc herniations. With improvement in optics, endoscopes, endoscopic drills and shavers, irrigation pumps, there has been a paradigm shift. Endoscopic spine surgery can now be performed with high magnification thus allowing its application not only to lumbar spinal stenosis, but also to spinal fusion surgeries, cervical and thoracic pathology as well. There has been increasing evidence in support of these newer techniques of spine surgery. For the purpose of this review, we studied current available literature and outlined the historical evolution of endoscopic spine surgery, the various different endoscopic systems, and techniques available and the current applications of endoscopic techniques as an alternative to traditional spinal surgery.

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Utilization of Spinal Navigation to Facilitate Hassle-Free Rod Placement during Minimally-Invasive Long-Construct Posterior Instrumentation

Cited by 4 publications

References 15 publications

Incidence of pedicle breach following open and minimally invasive spinal instrumentation: A postoperative CT analysis of 513 pedicle screws applied under fluoroscopic guidance

Incidence of pedicle breach following open and minimally invasive spinal instrumentation: A postoperative CT analysis of 513 pedicle screws applied under fluoroscopic guidance

Evolution, Current Trends, and Latest Advances of Endoscopic Spine Surgery

Evolution, Current Trends and Latest Advances of Endoscopic Spine Surgery: A Narrative Review

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