20 Tips to Avoid and Handle Problems in the Placement of Percutaneous Pedicle Screws
| Autor: | Alfredo Guiroy, Alberto Ofenhejm Gotfryd, Alejandro Morales Ciancio, Cristiano Menezes, Santiago Hem, Sebastián Kornfeld, Federico Landriel, Nestor Taboada |
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| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
Vertebral Body Percutaneous Operative Time Patient Positioning 03 medical and health sciences 0302 clinical medicine Pedicle Screws Monitoring Intraoperative medicine Humans Minimally Invasive Surgical Procedures Kirschner wire Intraoperative Complications Pedicle screw Posterior fusion business.industry Optical Imaging Minimally invasive spine surgery Magnetic Resonance Imaging Bevel Surgery 030220 oncology & carcinogenesis Neurology (clinical) business 030217 neurology & neurosurgery |
| Zdroj: | World Neurosurgery. 149:15-25 |
| ISSN: | 1878-8750 |
| DOI: | 10.1016/j.wneu.2021.01.149 |
| Popis: | Background Two-dimensional fluoroscopy-guided percutaneous pedicle screw placement is currently the most widely applied instrumentation for minimally invasive treatment of spinal injuries requiring stabilization. Although this technique has advantages over open instrumentation, it also presents new challenges and specific complications. The objective of this study was to provide recommendations developed from the experience of several spinal surgeons at different minimally invasive spine surgery reference centers to solve specific problems and prevent complications during the learning curve of this technique. Methods An AO Spine Latin America minimally invasive spine surgery study group analyzed the most frequent complications and challenges occurring during the placement of >14,000 two-dimensional fluoroscopy–guided percutaneous pedicle screws at different centers over 15 years. Twenty tips considered most relevant to performing this technique, excluding problems directly related to specific brands of instruments, were presented. Results The 20 tips included the following: (1) positioning; (2) clean and painless; (3) fewer x-rays; (4) check the clock; (5) beveled tip; (6) transverse-rib-pedicle; (7) double Jamshidi; (8) hammer the Kirschner wire; (9) bent tip; (10) too loose, too tight; (11) new trajectory; (12) manual control; (13) start over; (14) Kirschner wire first; (15) adhesive drape control; (16) bend the rod; (17) lower rods; (18) freehand inner; (19) posterior fusion; (20) revision. Conclusions Implementation of these tips might improve performance of this technique and reduce the complications related to percutaneous pedicle screw placement. |
| Databáze: | OpenAIRE |
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