Evaluation of the implantation of transpedicular screws in spinal instrumentation with free-hand technique and navigation-assisted with intraoperative computed tomography: An analytical-positional study
| Autor: | Cesáreo Conde Alonso, José Luis Thenier-Villa, Adolfo Ramón De La Lama Zaragoza, Pedro Miguel González-Vargas, Álvaro Martín-Gallego, Lourdes Calero Félix |
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| Rok vydání: | 2020 |
| Předmět: |
musculoskeletal diseases
medicine.medical_specialty Transpedicular instrumentation Hand technique Computed tomography Neurosurgical Procedures 03 medical and health sciences 0302 clinical medicine Pedicle Screws Humans Medicine In patient Spinal instrumentation medicine.diagnostic_test business.industry musculoskeletal system University hospital Spinal Fusion Fluoroscopy Surgery Neurology (clinical) Intraoperative ct Neurosurgery Tomography X-Ray Computed business Nuclear medicine 030217 neurology & neurosurgery |
| Zdroj: | Neurocirugia (English Edition). |
| ISSN: | 2529-8496 |
| Popis: | Background Spinal instrumentation using transpedicular screws has been used for decades to stabilize the spine. In October 2018, an intraoperative CT system was acquired in the Neurosurgery service of the University Hospital Complex of Vigo, this being the first model of these characteristics in the Spanish Public Health System, so we began a study from January 2015 to December 2019 to assess the precision of the transpedicular screws implanted with this system compared with a control group performed with the classical technique and final fluoroscopic control. Methods The study was carried out in patients who required transpedicular instrumentation surgery, in total 655 screws were placed, 339 using the free-hand technique (Group A) and 316 assisted with intraoperative CT navigation (Group B) (p > 0.05). Demographic characteristics, related to surgery and the screw implantation grades were assessed using the Gertzbein–Robbins classification. Results 92 patients were evaluated, between 12 and 86 years (average: 57.1 years). 161 thoracic screws (24.6%) and 494 lumbo-sacral screws (75.4%) were implanted. Of the thoracic screws, 33 produced a pedicle rupture. For the lumbo-sacral screws, 71 have had pedicle violation. The overall correct positioning rate for the free-hand group was 72.6% and for the CT group it was 96.5% (p Conclusion The accuracy rate is higher in thoracic-lumbar instrumentation in the navigation group versus free-hand group with fluoroscopic control. |
| Databáze: | OpenAIRE |
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