O-arm Assisted Cervicothoracic Spine Pedicle Screw Placement Accuracy is higher than C-arm Fluoroscopy

2021 ◽  
Author(s):  
Tomohisa Inoue ◽  
Keiji Wada ◽  
Ayako Tominaga ◽  
Ryo Tamaki ◽  
Tomoya Hirota ◽  
...  
Keyword(s):  
Pedicle Screw ◽  
Screw Placement ◽  
Pedicle Screw Placement ◽  
Placement Accuracy

scholarly journals Anatomical and radiologic characteristics of isthmus parameters in guiding pedicle screw placement

2018 ◽  
Vol 46 (6) ◽  
pp. 2386-2397 ◽  
Author(s):  
Paerhati Rexiti ◽  
Yakufu Abulizi ◽  
Aikeremujiang Muheremu ◽  
Shuiquan Wang ◽  
Maierdan Maimaiti ◽  
...  
Keyword(s):  
Pedicle Screw ◽  
Pedicle Screws ◽  
Screw Placement ◽  
Lumbar Spine Surgery ◽  
X Rays ◽  
Pedicle Screw Placement ◽  
Chinese Han ◽  
Before And After ◽  
Placement Accuracy ◽  
D Value

Objective To study the clinical application of lumbar isthmus parameters in guiding pedicle screw placement. Methods Lumbar isthmus parameters were measured in normal lumbar x-rays and cadaveric specimens from a Chinese Han population. Distance between the medial pedicle border and lateral isthmus border was recorded as a ‘D’ value and was compared between X-rays and cadavers. Orthopaedic surgeons estimated different distances (2–6 mm) and angles (5–20°), and bias ratios between estimated and real values were compared. Orthopaedic residents placed pedicle screws on cadaveric specimens before and after application of the ‘D’ value, and screw placement accuracy was compared. Results Except for L4 vertebrae, significant differences in the ‘D’ value were found between 25 cadaveric specimens and x-ray films from 120 patients. Distances and angles estimated by 40 surgeons were significantly different from all real values, except 2 mm distance. Accuracy of pedicle screw placement by six orthopaedic residents was significantly improved by applying the ‘D’ value. Conclusions Surgeon estimates of distance were more accurate than angle estimates. Addition of a ‘D’ value to conventional parameters may significantly improve pedicle screw placement accuracy in lumbar spine surgery.

806 Virtual Fluoroscopy Improves Lumbar Pedicle Screw Placement Accuracy

Neurosurgery ◽  
2000 ◽  
Vol 47 (2) ◽  
pp. 530-530 ◽  
Author(s):  
Kevin T. Foley ◽  
Ramesh L. Sahjpaul ◽  
Gerald R. Rodts
Keyword(s):  
Pedicle Screw ◽  
Screw Placement ◽  
Pedicle Screw Placement ◽  
Placement Accuracy ◽  
Lumbar Pedicle

Methods to determine pedicle screw placement accuracy in spine surgery: a systematic review

2015 ◽  
Vol 24 (5) ◽  
pp. 990-1004 ◽  
Author(s):  
Ahmed A. Aoude ◽  
Maryse Fortin ◽  
Rainer Figueiredo ◽  
Peter Jarzem ◽  
Jean Ouellet ◽  
...  
Keyword(s):  
Systematic Review ◽  
Pedicle Screw ◽  
Spine Surgery ◽  
Screw Placement ◽  
Pedicle Screw Placement ◽  
Placement Accuracy

A new tool to improve pedicle screw placement accuracy in navigated spine surgery: a monocentric study

2021 ◽  
Vol 65 (3) ◽  
Author(s):  
Giovanni NICOLETTI ◽  
Massimo FURNARI ◽  
Massimiliano GIUFFRIDA ◽  
Giancarlo PONZO ◽  
Domenico G. IACOPINO ◽  
...  
Keyword(s):  
Pedicle Screw ◽  
Spine Surgery ◽  
Screw Placement ◽  
Pedicle Screw Placement ◽  
Placement Accuracy ◽  
Navigated Spine Surgery

Pedicle screw placement accuracy in thoracic and lumbar spinal surgery with a patient-matched targeting guide: a cadaveric study

2015 ◽  
Vol 24 (S7) ◽  
pp. 937-941 ◽  
Author(s):  
Claudio Lamartina ◽  
Riccardo Cecchinato ◽  
Zsolt Fekete ◽  
Alberto Lipari ◽  
Meinrad Fiechter ◽  
...  
Keyword(s):  
Pedicle Screw ◽  
Spinal Surgery ◽  
Cadaveric Study ◽  
Screw Placement ◽  
Pedicle Screw Placement ◽  
Placement Accuracy ◽  
Lumbar Spinal Surgery ◽  
Lumbar Spinal

Facet Violation With Percutaneous Pedicle Screw Placement: Impact of 3D Navigation and Facet Orientation

2021 ◽  
pp. 155633162110263
Author(s):  
Ting Cong ◽  
Ahilan Sivaganesan ◽  
Christopher M. Mikhail ◽  
Avani S. Vaishnav ◽  
James Dowdell ◽  
...  
Keyword(s):  
Pedicle Screw ◽  
Screw Placement ◽  
Radiographic Measurement ◽  
Pedicle Screw Placement ◽  
3D Navigation ◽  
3 Dimensional ◽  
Computed Tomographic ◽  
Percutaneous Pedicle Screw ◽  
Facet Orientation ◽  
Placement Accuracy

Background: The gold standard for percutaneous pedicle screw placement is 2-dimensional (2D) fluoroscopy. Data are sparse on the accuracy of 3-dimensional (3D) navigation percutaneous screw placement in minimally invasive spine procedures. Objective: We sought to compare a single surgeon’s percutaneous pedicle screw placement accuracy using 2D fluoroscopy versus 3D navigation, as well as to investigate the effect of facet orientation on facet violation when using 2D fluoroscopy. Methods: We conducted a retrospective radiographic study of consecutive cohort of patients who underwent percutaneous lumbar instrumentation using either 2D fluoroscopy or 3D navigation. All procedures were performed by a single surgeon at 2 academic institutions between 2011 and 2018. Radiographic measurement of screw accuracy was assessed using a postoperative computed tomographic scan. The primary outcome was facet violation, and secondary outcomes were endplate/tip breaches, the Gertzbein-Robbins classification for cortical breaches, and the Simplified Screw Accuracy grade. Statistical comparisons were made between screws placed using 2D fluoroscopy versus 3D navigation. Axial facet angles were also measured to correlate with facet violation rates. Results: In the 138 patients included, 376 screws were placed with fluoroscopy and 193 with navigation. Superior (unfused) level facet violation was higher with 2D fluoroscopy than with 3D navigation (9% vs 0.5%), which comprises the main cause for poor screw placement. Axial facet angles exceeding 45° at L4 and 60° at L5 were correlated with facet violations. Conclusion: This retrospective study found that 3D navigation is associated with lower facet violation rates in percutaneous lumbar pedicle screw placement when compared with 2D fluoroscopy. These findings suggest that 3D navigation may be of particular value when facet joints are coronally oriented.

Comparing the Efficacy of Radiation Free Machine-Vision Image-Guided Surgery With Traditional 2-Dimensional Fluoroscopy: : A Randomized, Single-Center Study

2021 ◽  
pp. 155633162110298
Author(s):  
Jessica Dorilio ◽  
Nicole Utah ◽  
Christina Dowe ◽  
Fedan Avrumova ◽  
Daniel Alicea ◽  
...  
Keyword(s):  
Pedicle Screw ◽  
Navigation System ◽  
Operative Time ◽  
Screw Placement ◽  
Image Guided Surgery ◽  
Pedicle Screw Placement ◽  
Guided Surgery ◽  
Image Guided ◽  
Placement Accuracy ◽  
Radiation Exposure To Patients

Background: Three-dimensional (3D) computer-assisted navigation (CAN) has emerged as a potential alternative to 2-dimensional (2D) fluoroscopy in the surgical placement of spinal instrumentation. Recently, 3D-CAN systems have improved significantly in their ability to provide real-time anatomical referencing while shortening the registration and set-up time. A novel system in navigation, Machine-Vision Image-Guided Surgery (MvIGS; 7D Surgical, Toronto, Canada) was cleared by the US Food and Drug Administration, but its potential benefits in reducing intra-operative radiation exposure to patients and enhancing surgical accuracy of pedicle screw placement are not fully known. Purpose: We sought to conduct a prospective, randomized, clinical study comparing the 3D-MvIGS spinal navigation system and 2D-fluoroscopy for pedicle screw insertion up to 3 levels (T10-S1) and for various measures of surgical efficacy. Methods: Sixty-two eligible patients were randomized to receive spine surgery using either the 3D-MvIGS group or the conventional 2D-fluoroscopy for pedicle screw fixation for the treatment of spinal stenosis and degenerative spondylolisthesis. Intra-operative parameters and procedure-related unintended protocol violations were recorded. Results: Operative time and estimated blood loss were not significantly different between groups. Radiation time and exposure to patients were significantly reduced in the 3D-MvIGS group. There was no difference between groups in pedicle screw placement accuracy (2D-fluoroscopy group, 96.6%; 3D-MvIGS group, 94.2%). There were no major complications or cases that required revision surgery. Conclusion: The 3D-MvIGS navigation system performed comparably with 2D-fluoroscopy in terms of pedicle screw placement accuracy and operative time. The 3D-MvIGS showed a significant reduction in radiation exposure to patients. In more complex cases or larger cohorts, the true value of greater anatomical visualization can be elucidated.

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