Manual and Computer-Assisted Pedicle Screw Placement Plans: A Quantitative Comparison

2016 ◽  
pp. 105-115 ◽  
Author(s):  
Dejan Knez ◽  
Janez Mohar ◽  
Robert J. Cirman ◽  
Boštjan Likar ◽  
Franjo Pernuš ◽  
...  
Keyword(s):  
Pedicle Screw ◽  
Quantitative Comparison ◽  
Screw Placement ◽  
Computer Assisted ◽  
Pedicle Screw Placement

Variability Analysis of Manual and Computer-Assisted Preoperative Thoracic Pedicle Screw Placement Planning

Spine ◽  
2018 ◽  
Vol 43 (21) ◽  
pp. 1487-1495 ◽  
Author(s):  
Dejan Knez ◽  
Janez Mohar ◽  
Robert J. Cirman ◽  
Boštjan Likar ◽  
Franjo Pernuš ◽  
...  
Keyword(s):  
Pedicle Screw ◽  
Screw Placement ◽  
Computer Assisted ◽  
Pedicle Screw Placement ◽  
Variability Analysis ◽  
Thoracic Pedicle Screw

Feasibility and accuracy of computer-assisted individual drill guide template for minimally invasive lumbar pedicle screw placement trajectory

Injury ◽  
2018 ◽  
Vol 49 (3) ◽  
pp. 644-648 ◽  
Author(s):  
Hongwei Wang ◽  
Yusheng Liu ◽  
Yiwen Zhao ◽  
Guoli Song ◽  
Jun Liu ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Pedicle Screw ◽  
Screw Placement ◽  
Computer Assisted ◽  
Pedicle Screw Placement ◽  
Drill Guide ◽  
Drill Guide Template ◽  
Lumbar Pedicle

Fluoroscopic Computer-Assisted Pedicle Screw Placement Through a Mature Fusion Mass

Spine ◽  
2007 ◽  
Vol 32 (2) ◽  
pp. 217-222 ◽  
Author(s):  
Yoga Raja Rampersaud ◽  
Kwang-Soo Lee
Keyword(s):  
Pedicle Screw ◽  
Screw Placement ◽  
Computer Assisted ◽  
Pedicle Screw Placement

Accuracy of Computer-Assisted Pedicle Screw Placement

Spine ◽  
1997 ◽  
Vol 22 (4) ◽  
pp. 452-458 ◽  
Author(s):  
Othmar Schwarzenbach ◽  
Ulrich Berlemann ◽  
Bernhard Jost ◽  
Heiko Visarius ◽  
Erich Arm ◽  
...  
Keyword(s):  
Pedicle Screw ◽  
Screw Placement ◽  
Computer Assisted ◽  
Pedicle Screw Placement

Clinical accuracy of three-dimensional fluoroscopy-based computer-assisted cervical pedicle screw placement: a retrospective comparative study of conventional versus computer-assisted cervical pedicle screw placement

2010 ◽  
Vol 13 (5) ◽  
pp. 606-611 ◽  
Author(s):  
Yoshimoto Ishikawa ◽  
Tokumi Kanemura ◽  
Go Yoshida ◽  
Zenya Ito ◽  
Akio Muramoto ◽  
...  
Keyword(s):  
Pedicle Screw ◽  
Three Dimensional ◽  
Screw Placement ◽  
Computer Assisted ◽  
Pedicle Screw Placement ◽  
Cervical Pedicle Screw ◽  
Retrospective Clinical Study ◽  
Significant Difference ◽  
Cervical Pedicle ◽  
Grade 3

Object The authors performed a retrospective clinical study to evaluate the feasibility and accuracy of cervical pedicle screw (CPS) placement using 3D fluoroscopy-based navigation (3D FN). Methods The study involved 62 consecutive patients undergoing posterior stabilization of the cervical spine between 2003 and 2008. Thirty patients (126 screws) were treated using conventional techniques (CVTs) with a lateral fluoroscopic view, whereas 32 patients (150 screws) were treated using 3D FN. Screw positions were classified into 4 grades based on the pedicle wall perforations observed on postoperative CT. Results The prevalence of perforations in the CVT group was 27% (34 screws): 92 (73.0%), 12 (9.5%), 6 (4.8%), and 16 (12.7%) for Grade 0 (no perforation), Grade 1 (perforation < 1 mm), Grade 2 (perforation ≥ 1 and < 2 mm), and Grade 3 (perforation ≥ 2 mm), respectively. In the 3D FN group, the prevalence of perforations was 18.7% (28 screws): 122 (81.3%), 17 (11.3%), 6 (4%), and 5 (3.3%) for Grades 0, 1, 2, and 3, respectively. Statistical analysis showed no significant difference in the prevalence of Grade 1 or higher perforations between the CVT and 3D FN groups. A higher prevalence of malpositioned CPSs was seen in Grade 2 or higher (17.5% vs 7.3%, p < 0.05) in the 3D FN group and Grade 3 (12.7% vs 7.3%, p < 0.05) perforations in the CVT group. The ORs for CPS malpositioning in the CVT group were 2.72 (95% CI 1.16–6.39) in Grade 2 or higher perforations and 3.89 (95% CI 1.26–12.02) in Grade 3 perforations. Conclusions Three-dimensional fluoroscopy-based navigation can improve the accuracy of CPS insertion; however, severe CPS malpositioning that causes injury to the vertebral artery or neurological complications can occur even with 3D FN. Advanced techniques for the insertion of CPSs and the use of modified insertion devices can reduce the risk of a malpositioned CPS and provide increased safety.

scholarly journals Charactor of Modality and Resident Level in Pedicle Screw Accuracy and Neurosurgical Education

2018 ◽  
Vol 2 (1) ◽  
pp. 01-04
Author(s):  
Anbis El Hakim
Keyword(s):  
Pedicle Screw ◽  
Medical Center ◽  
Pedicle Screws ◽  
Screw Placement ◽  
Computer Assisted ◽  
Training Methods ◽  
Pedicle Screw Placement ◽  
Starting Point ◽  
Grade 3 ◽  
Efficient Learning

Objective: Evolving pressure on surgical education necessitates safe and efficient learning of techniques. We evaluated the effect of training year using anatomic, percutaneous fluoroscopy guided and computer navigated techniques on the accuracy of pedicle screw placement to attempt to determine if different modalities may be better suited for different levels of training. Methods: All instrumented thoracic and lumbar cases performed at Detroit Medical Center by the Neurosurgery Service between August 2012 and June 2013 were included.Cases had hardware verified by post-operative CT. Hardware placement was graded according to Mirza SK et al., grade 0 (within pedicle), grade 1 (< 2 mm breach), grade 2 (> 2 mm breach) , and grade 3 (extrapedicular). Pedicle screws were reviewed independently by a resident and attending surgeon. Rates of pedicle breach, EBL, length of case, pedicle size and pedicle starting point were all reviewed. Pedicles were analyzed on PACS system in axial views, using sagittal views to identify the correct level. Results: A total of 306 pedicle screws were evaluated in 36 patients. The overall rate of accurate pedicle screw placement among residents defined as Grade 0 or 1 placement was 86.8%.Fluoroscopically placed screws had significantly less breaches than anatomic screws 11% vs 20% (p = 0.03). Fluoroscopic cases had significantly less medial breeches (20%) than anatomic (50%) (p < 0.05) and computer assisted cases (73%) (p < 0.05). EBL values for fluoroscopic, anatomic and Body Tom cases were 425 cc, 720 cc, and 816 cc respectively. Resident level was found to be inversely proportional to breech rate (R squared 0.45). We did not see any clear difference in breach rate for resident level in different modalities. Conclusion: Supervised neurosurgical residents can place pedicle screws within published rates of acceptable breach. Interestingly our study revealed an inverse relationship between resident experience and pedicle screw accuracy. Fluoroscopic placement of pedicle screws compared to computer assisted and anatomic techniques results in lower medial breach rate and may be better suited for junior level residents.

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