scholarly journals Letter to the Editor on “Transpedicular Screw Placement Accuracy Using the O-Arm Versus Freehand Technique at a Single Institution. Global Spine Journal” by Crawford et al

2021 ◽  
Vol 11 (3) ◽  
pp. 416-417
Author(s):  
Bhavuk Garg ◽  
Nishank Mehta
Keyword(s):  
Screw Placement ◽  
Single Institution ◽  
Letter To The Editor ◽  
Freehand Technique ◽  
Transpedicular Screw ◽  
Placement Accuracy

scholarly journals Transpedicular Screw Placement Accuracy Using the O-Arm Versus Freehand Technique at a Single Institution

2020 ◽  
pp. 219256822095697
Author(s):  
Benjamin D. Crawford ◽  
Corbyn M. Nchako ◽  
Kelsey A. Rebehn ◽  
Heidi Israel ◽  
Howard M. Place
Keyword(s):  
Pedicle Screw ◽  
Intraoperative Imaging ◽  
Pedicle Screws ◽  
Screw Placement ◽  
Spinal Level ◽  
Imaging Tool ◽  
Freehand Technique ◽  
Transpedicular Screw ◽  
Significant Difference ◽  
Placement Accuracy

Study Design: Retrospective cohort. Objective: The objective of this study was to assess the effectiveness of the O-arm as an intraoperative imaging tool by comparing accuracy of pedicle screw placement to freehand technique. Methods: The study comprised a total of 1161 screws placed within the cervical (n = 187) thoracic (n = 657), or lumbar (n = 317) spinal level. A pedicle breach was determined by any measurable displacement of the screw outside of the pedicle cortex in any plane on postoperative images. Each pedicle screw was subsequently classified by its placement relative to the targeted pedicle. Statistical analysis was then performed to determine the frequency and type of pedicle screw mispositioning that occurred using the O-arm versus freehand technique. Results: A total of 155 cases (O-arm 84, freehand 71) involved the placement of 454 pedicle screws in the O-arm group and 707 pedicle screws in the freehand group. A pedicle breach occurred in 89 (12.6%) screws in the freehand group and 55 (12.1%) in the O-arm group ( P = .811). Spinal level operated upon did not influence pedicle screw accuracy between groups ( P > .05). Three screws required revision surgery between the 2 groups (O-arm 1, freehand 2, P > .05). The most frequent breach type was a lateral pedicle breach (O-arm 22/454, 4.8%; freehand 54/707, 7.6%), without a significant difference between groups ( P > .05). Conclusions: The use of the O-arm coupled with navigation does not assure improved transpedicular screw placement accuracy when compared with the freehand technique.

Letter to the Editor Regarding: “Development of a Novel 3D-Printed Phantom for Teaching Neurosurgical Trainees the Freehand Technique of C2 Laminar Screw Placement”

2020 ◽  
Vol 136 ◽  
pp. 437-438
Author(s):  
Dimitrios Chytas ◽  
George C. Babis ◽  
Efstathios Chronopoulos ◽  
Maria-Kyriaki Kaseta ◽  
Konstantinos Markatos ◽  
...  
Keyword(s):  
Screw Placement ◽  
Laminar Screw ◽  
Letter To The Editor ◽  
Freehand Technique ◽  
3D Printed ◽  
C2 Laminar Screw

scholarly journals Accuracy of 2D Fluoroscopy with Preoperative CT Fused Neuronavigation in Thoracic and Lumbar Pedicle Screw Insertion

2020 ◽  
pp. 20-25
Author(s):  
Adrian Bălașa ◽  
Corina-Ionela Hurghiș ◽  
Flaviu Tămaș ◽  
Ioan-Alexandru Florian ◽  
Levente Peter ◽  
...  
Keyword(s):  
Pedicle Screw ◽  
Spinal Instrumentation ◽  
Pedicle Screw Fixation ◽  
Screw Placement ◽  
Pedicle Screw Placement ◽  
Screw Insertion ◽  
Freehand Technique ◽  
Preoperative Ct ◽  
Placement Accuracy ◽  
The Difference

Aim: Pedicle screw fixation is an established technique in the lumbar and thoracic area. Fluoroscopy-guided screw placement and subsequently navigation have decreased the rate of misplaced screws, but no technique has wholly eliminated this risk. This paper aims to study the difference between the accuracy of the fluoroscopic guided screw placement to that of the 2D fluoroscopy- preop CT fused neuronavigation guided technique, a lesser-used navigation technique.  Material and Methods: This retrospective study reflects our results using both techniques between March 2018 and March 2019 in both degenerative or traumatic spinal pathology for thoracic and lumbar regions. The accuracy of the screw placement was measured using Mirza grading system on postoperative CT images. Results: A total number of 56 patients underwent spinal instrumentation surgery. A total of 274 screws were placed with a mean number of 4.89 screws per patient; 199 screws were implanted using neuronavigation and 75 using the freehand-2D fluoroscopy-guided technique.  The accuracy rate of pedicle screw placement in the freehand technique guided by 2D fluoroscopy was 88,00%. With the use of neuronavigation, the accuracy increased to 89,96%. Conclusion:  Pedicle screw placement accuracy is higher when guided by CT-fluoro matching neuronavigation compared to freehand fluoroscopy-guided technique and can be used in departments where there is no intraoperative O-arm or 3D fluoroscopy available.

scholarly journals A five-step remedial screw placement method to treat severe spinal deformity with free-hand transpedicular screw placement

2012 ◽  
Vol 22 (2) ◽  
pp. 417-424 ◽  
Author(s):  
Jing-Ming Xie ◽  
Zhi Zhao ◽  
Hua Yang ◽  
Ying-Song Wang ◽  
Ying Zhang ◽  
...  
Keyword(s):  
Spinal Deformity ◽  
Screw Placement ◽  
Placement Method ◽  
Transpedicular Screw ◽  
Severe Spinal Deformity

Morphometry of the Thoracic and Lumbar Spine Related to Transpedicular Screw Placement for Surgical Spinal Fixation

Spine ◽  
1988 ◽  
Vol 13 (1) ◽  
pp. 27-32 ◽  
Author(s):  
MARTIN H. KRAG ◽  
DONALD L. WEAVER ◽  
BRUCE D. BEYNNON ◽  
LARRY D. HAUGH
Keyword(s):  
Lumbar Spine ◽  
Screw Placement ◽  
Spinal Fixation ◽  
Transpedicular Screw ◽  
Thoracic And Lumbar Spine

scholarly journals Initial Single-Institution Experience With a Novel Robotic-Navigation System for Thoracolumbar Pedicle Screw and Pelvic Screw Placement With 643 Screws

10.14444/6060 ◽  
2019 ◽  
Vol 13 (5) ◽  
pp. 459-463 ◽  
Author(s):  
DEEPTEE JAIN ◽  
JORDAN MANNING ◽  
ELIZABETH LORD ◽  
THEMISTOCLES PROTOPSALTIS ◽  
YONG KIM ◽  
...  
Keyword(s):  
Pedicle Screw ◽  
Navigation System ◽  
Screw Placement ◽  
Robotic Navigation ◽  
Single Institution

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.

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