scholarly journals Accuracy of Pedicle Screw Placement in Scoliosis Surgery: A Comparison between Conventional Computed Tomography-Based and O-Arm-Based Navigation Techniques

2014 ◽  
Vol 8 (3) ◽  
pp. 331 ◽  
Author(s):  
Toshiaki Kotani ◽  
Tsutomu Akazawa ◽  
Tsuyoshi Sakuma ◽  
Kayo Koyama ◽  
Tetsuharu Nemoto ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Pedicle Screw ◽  
Screw Placement ◽  
Scoliosis Surgery ◽  
Pedicle Screw Placement

Accuracy of Subaxial Cervical Pedicle Screw Placement Using Direct Visualization Versus Computed Tomography–Based Navigation

2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
S. Harrison Farber ◽  
Jakub Godzik ◽  
Randall J. Hlubek ◽  
James J. Zhou ◽  
Corey T. Walker ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Pedicle Screw ◽  
Screw Placement ◽  
Direct Visualization ◽  
Pedicle Screw Placement ◽  
Cervical Pedicle Screw ◽  
Cervical Pedicle

scholarly journals Confirmation of accuracy/inaccuracy of lumbar pedicle screw placement using postoperative computed tomography

2021 ◽  
Vol 12 ◽  
pp. 518
Author(s):  
Mohamed M. Arnaout ◽  
Magdy O. ElSheikh ◽  
Mansour A. Makia
Keyword(s):  
Computed Tomography ◽  
Lumbar Spine ◽  
Pedicle Screw ◽  
Pedicle Screws ◽  
Operative Intervention ◽  
Screw Placement ◽  
Lumbar Spine Surgery ◽  
Pedicle Screw Placement ◽  
Lumbar Pedicle ◽  
Ct Studies

Background: Transpedicular screws are extensively utilized in lumbar spine surgery. The placement of these screws is typically guided by anatomical landmarks and intraoperative fluoroscopy. Here, we utilized 2-week postoperative computed tomography (CT) studies to confirm the accuracy/inaccuracy of lumbar pedicle screw placement in 145 patients and correlated these findings with clinical outcomes. Methods: Over 6 months, we prospectively evaluated the location of 612 pedicle screws placed in 145 patients undergoing instrumented lumbar fusions addressing diverse pathology with instability. Routine anteroposterior and lateral plain radiographs were obtained 48 h after the surgery, while CT scans were obtained at 2 postoperative weeks (i.e., ideally these should have been performed intraoperatively or within 24–48 h of surgery). Results: Of the 612 screws, minor misplacement of screws (≤2 mm) was seen in 104 patients, moderate misplacement in 34 patients (2–4 mm), and severe misplacement in 7 patients (>4 mm). Notably, all the latter 7 (4.8% of the 145) patients required repeated operative intervention. Conclusion: Transpedicular screw insertion in the lumbar spine carries the risks of pedicle medial/lateral violation that is best confirmed on CT rather than X-rays/fluoroscopy alone. Here, we additional found 7 patients (4.8%) who with severe medial/lateral pedicle breach who warranting repeated operative intervention. In the future, CT studies should be performed intraoperatively or within 24–48 h of surgery to confirm the location of pedicle screws and rule in our out medial or lateral pedicle breaches.

Stepwise Methodology for Plain Radiographic Assessment of Pedicle Screw Placement: A Comparison With Computed Tomography

2006 ◽  
Vol 19 (8) ◽  
pp. 547-553 ◽  
Author(s):  
Theodore J. Choma ◽  
Francis Denis ◽  
John E. Lonstein ◽  
Joseph H. Perra ◽  
James D. Schwender ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Pedicle Screw ◽  
Screw Placement ◽  
Radiographic Assessment ◽  
Pedicle Screw Placement

Accuracy Analysis of Pedicle Screw Placement in Posterior Scoliosis Surgery

Spine ◽  
2007 ◽  
Vol 32 (14) ◽  
pp. 1543-1550 ◽  
Author(s):  
Yoshihisa Kotani ◽  
Kuniyoshi Abumi ◽  
Manabu Ito ◽  
Masahiko Takahata ◽  
Hideki Sudo ◽  
...  
Keyword(s):  
Pedicle Screw ◽  
Screw Placement ◽  
Scoliosis Surgery ◽  
Accuracy Analysis ◽  
Pedicle Screw Placement

Inter- and Intraobserver Reliability of Computed Tomography in Assessment of Thoracic Pedicle Screw Placement

Spine ◽  
2003 ◽  
Vol 28 (22) ◽  
pp. 2527-2530 ◽  
Author(s):  
Ganesh Rao ◽  
Darrel S. Brodke ◽  
Matthew Rondina ◽  
Kent Bacchus ◽  
Andrew T. Dailey
Keyword(s):  
Computed Tomography ◽  
Pedicle Screw ◽  
Intraobserver Reliability ◽  
Screw Placement ◽  
Pedicle Screw Placement ◽  
Thoracic Pedicle Screw

Computed Tomography-Guided C2 Pedicle Screw Placement for Treatment of Unstable Hangman Fractures

Spine ◽  
2014 ◽  
Vol 39 (18) ◽  
pp. E1058-E1065 ◽  
Author(s):  
Pankaj Kumar Singh ◽  
Kanwaljeet Garg ◽  
Duttaraj Sawarkar ◽  
Deepak Agarwal ◽  
Guru Dutta Satyarthee ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Pedicle Screw ◽  
Screw Placement ◽  
Pedicle Screw Placement ◽  
C2 Pedicle Screw

Pediatric Pedicle Screw Placement Using Intraoperative Computed Tomography and 3-Dimensional Image-Guided Navigation

Spine ◽  
2012 ◽  
Vol 37 (3) ◽  
pp. E188-E194 ◽  
Author(s):  
A. Noelle Larson ◽  
Edward R. G. Santos ◽  
David W. Polly ◽  
Charles G. T. Ledonio ◽  
Jonathan N. Sembrano ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Pedicle Screw ◽  
Screw Placement ◽  
Pedicle Screw Placement ◽  
Intraoperative Computed Tomography ◽  
3 Dimensional ◽  
Dimensional Image ◽  
Image Guided

scholarly journals Efficacy and safety for combination of t-EMG with O-arm assisted pedicle screw placement in neurofibromatosis type I scoliosis surgery

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Xiexiang Shao ◽  
Zifang Huang ◽  
Jingfan Yang ◽  
Yaolong Deng ◽  
Junlin Yang ◽  
...  
Keyword(s):  
Pedicle Screw ◽  
Pedicle Screws ◽  
Neurofibromatosis Type ◽  
Screw Placement ◽  
Type I ◽  
Scoliosis Surgery ◽  
Neurofibromatosis Type I ◽  
Efficacy And Safety ◽  
Pedicle Screw Placement ◽  
Channel Classification

Abstract Background Due to the characteristics of neurofibromatosis type I (NF-1) scoliosis, the precise placement of pedicle screws still remains to be a challenge. Triggered screw electromyography (t-EMG) has been proved to exhibit high sensitivity to identify mal-positioned pedicle screws, but no previous study assessed the combination of t-EMG with O-arm-assisted pedicle screw placement in NF-1 scoliosis surgery. Objective To evaluate efficacy and safety for combination of t-EMG with O-arm-assisted pedicle screw placement in NF-1 scoliosis surgery. Materials and methods From March 2018 to April 2020, sixty-five NF-1 scoliosis patients underwent t-EMG and O-arm-assisted pedicle screw fixation were retrospectively reviewed. The channel classification system was applied to classify the pedicle morphology based on pedicle width measurement by preoperative computed tomography scans. The minimal t-EMG threshold for screw path inspection was used as 8 mA, and operative screw redirection was also recorded. All pedicle screws were verified using a second intraoperative O-arm scan. The correlation between demographic and clinical data with amplitude of t-EMG were also analyzed. Results A total of 652 pedicle screws (T10-S1) in 65 patients were analyzed. The incidence of an absent pedicle (channel classification type C or D morphology) was 150 (23%). Overall, abnormal t-EMG threshold was identified in 26 patients with 48 screws (7.4%), while 16 out of the 48 screws were classified as G0, 14 out of the 48 screws were classified as G1, and 18 out of the 48 screws were classified as G2. The screw redirection rate was 2.8% (18/652). It showed that t-EMG stimulation detected 3 unacceptable mal-positioned screws in 2 patients (G2) which were missed by O-arm scan. No screw-related neurological or vascular complications were observed. Conclusions Combination of t-EMG with O-arm-assisted pedicle screw placement was demonstrated to be a safe and effective method in NF-1 scoliosis surgery. The t-EMG could contribute to detecting the rupture of the medial wall which might be missed by O-arm scan. Combination of t-EMG with O-arm could be recommended for routine use of screw insertion in NF-1 scoliosis surgery.

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