Percutaneous pedicle screw placement with computer-navigated mapping in place of Kirschner wires
| Autor: | Eric M. Horn, Gregory M. Helbig, Thomas Gianaris |
|---|---|
| Rok vydání: | 2013 |
| Předmět: |
Adult
Male medicine.medical_specialty Percutaneous Radiography Bone Screws Bone Nails Thoracic Vertebrae Imaging Three-Dimensional medicine Humans Fluoroscopy Orthopedic Procedures Pedicle screw Aged Retrospective Studies Lumbar Vertebrae medicine.diagnostic_test business.industry Navigation system General Medicine Middle Aged Surgery Neurosurgical Procedure Radiation exposure Treatment Outcome Surgery Computer-Assisted Female Spinal Diseases Lumbar spine Radiology business Bone Wires |
| Zdroj: | Journal of Neurosurgery: Spine. 19:608-613 |
| ISSN: | 1547-5654 |
| DOI: | 10.3171/2013.7.spine121157 |
| Popis: | Object Percutaneous pedicle screw insertion techniques are commonly used to treat a variety of spinal disorders. Typically, Kirschner (K)-wires are used to guide the insertion of taps and screws during placement since the normal anatomical landmarks are not visualized. The use of K-wires adds risks, such as vascular and nerve injuries as well as increased radiation exposure given the use of fluoroscopy. The authors describe a series of patients who had percutaneous pedicle screws placed using a new computer-assisted navigation technique without the need for K-wires. Methods Minimally invasive percutaneous pedicle screw placement in the thoracic and lumbar spine was performed in a consecutive series of 15 patients for a variety of spinal pathologies. Intraoperative 3D CT images were obtained and used with a computer-assisted navigation system to insert an awl-tap into each pedicle. The tap location in the pedicle was marked with the navigation software, and the awl-tap was then removed. The navigation system was used to identify each landmark to insert the pedicle screw. Connecting rods were then inserted percutaneously under fluoroscopic guidance. Postoperative CT scans were obtained in each patient to evaluate screw placement. Results On postprocedure scanning, only 1 screw had a minor lateral and superior breach that was asymptomatic. To date, there have been no hardware failures. Conclusions Percutaneous pedicle screws can be placed effectively and safely without the use of K-wires. |
| Databáze: | OpenAIRE |
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