Prospective Evaluation of the Time Required for Insertion of 380 Lumbar and Sacral Pedicle Screws Using Navigation with an Intraoperative 3-Dimensional Imaging System.

Autor:	Ding BTK; Department of Orthopaedic Surgery, Tan Tock Seng Hospital, Singapore., Kaliya-Perumal AK; Department of Orthopaedic Surgery, Tan Tock Seng Hospital, Singapore., Oh JY; Department of Orthopaedic Surgery, Tan Tock Seng Hospital, Singapore., Yu CS; Department of Orthopaedic Surgery, Tan Tock Seng Hospital, Singapore.
Jazyk:	angličtina
Zdroj:	International journal of spine surgery [Int J Spine Surg] 2020 Jun 30; Vol. 14 (3), pp. 368-374. Date of Electronic Publication: 2020 Jun 30 (Print Publication: 2020).
DOI:	10.14444/7048
Abstrakt:	Background: The aim of this study was to evaluate the time required for various parts of the procedure to insert lumbar and sacral pedicle screws using navigation with an intraoperative, 3-dimensional imaging system. Comparison of these timings was carried out for different surgical indications. Methods: This was a single-surgeon prospective cohort study of 69 consecutive patients (between August 2013 and June 2018) who underwent insertion of 380 pedicle screws into the lumbar and sacral vertebrae. Surgical indications, average time required for surgical exposure and attachment of the reference frame, average time required until completion of the first pedicle screw insertion, and average time required for insertion of a single pedicle screw were evaluated. Results: The average time required from skin incision to reference frame attachment was 28.3 ± 20.4 (mean ± SD) minutes, and the average time required from reference frame attachment to completion of first pedicle screw insertion was 22.3 ± 9.6 minutes. The average time required for insertion of a single pedicle screw was 7.8 ± 2.7 minutes. When surgical indications were compared, the average time required for insertion of a single pedicle screw was 7.7 ± 2.6 minutes in surgery for spondylosis-related stenosis, 8.1 ± 2.8 minutes for degenerative scoliosis, and 8.2 ± 3.6 minutes for metastatic tumor ( P = .89). There were no significant changes in these timings over consecutive 6-month periods. Conclusions: There is no significant learning curve and no significant difference in navigation setup and pedicle screw insertion timings with intraoperative 3-dimensional navigation systems for surgeries of different pathologies and levels of surgery. Level of Evidence: 2. Competing Interests: Disclosures and COI: The authors declare no financial or intellectual conflicts of interest. No funding was received for the purpose of this study. Permissions have been granted to reproduce copyrighted materials and for patient consent forms. The study was approved by the institutional review board. (©International Society for the Advancement of Spine Surgery 2020.)
Databáze:	MEDLINE
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