A Novel Percutaneous Guide Wire (S-Wire) for Percutaneous Pedicle Screw Insertion

Ishii, Ken; Kaneko, Yasuhito; Funao, Haruki; Ishihara, Shinichi; Shinohara, Akira; Nakanishi, Kazuo; Hikata, Tomohiro; Fujita, Nobuyuki; Iwanami, Akio; Hosogane, Naobumi; Watanabe, Kota; Nagura, Takeo; Nakamura, Masaya; Toyama, Yoshiaki; Matsumoto, Morio

doi:10.1177/1553350614560271

Cited by 13 publications

(10 citation statements)

References 14 publications

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“…In our study, we did not analyze the PPS breach rate, but none of the patients experienced paralysis or leg pain after surgery or required reoperation to replace the screws. The third advantage of the guide wire-less method is that there is no risk of guide wire problems [19] given that the Viper Prime TM system does not use guide wires. Another advantage of the PPS insertion method with the patient in the lateral decubitus position method is that patient repositioning is not required, which should reduce medical costs [8].…”

Section: Discussionmentioning

confidence: 99%

The analysis of percutaneous pedicle screw technique with guide wire-less in lateral decubitus position following extreme lateral interbody fusion

Hiyama¹,

Sakai²,

Sato³

et al. 2019

J Orthop Surg Res

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Background Lateral lumbar interbody fusion (LLIF) and bilateral percutaneous pedicle fixation are valuable, minimally invasive lateral approaches used to treat symptomatic degenerative disc disease. In the current procedure, the patient’s position on the operating table is changed after LLIF surgery from the lateral decubitus to the prone position. The ability to perform both approaches with the patient in the same position should reduce operation time. Use of a guide wire is problematic during percutaneous pedicle screw (PPS) insertion using fluoroscopy with the patient in the lateral decubitus position. A new guide wire-less PPS system may solve this problem and reduce operation time. Here, we evaluated the operative data and efficacy for this technique. Methods This study included 30 patients (aged 70.8 ± 8.5 years; 17 men, 13 women) who underwent a combined operation (indirect decompression) using extreme lateral interbody fusion (XLIF) with only a single level for lumbar spinal canal stenosis and lumbar degenerative spondylolisthesis. Patient demographics and operative data were compared between two groups: patients who remained in the lateral decubitus position for pedicle screw fixation (L group) and those turned to the prone position (P group). Radiographic assessment was performed using pre- and postoperative anteroposterior and lateral lumbar films with measurement of lumbar lordosis, segmental lordosis, and segmental translation. Results We analyzed 18 patients in the P group and 12 in the L group. Age, sex, height, body weight, body mass index, estimated blood loss, and length of stay did not differ between groups. The operation time was 34 min shorter for the L group (P group 111.9 ± 25.0 vs. L group 77.5 ± 22.2 min, p < 0.01). Pre- and postoperative lordosis, segmental lordosis, and segmental translation did not differ significantly between groups. Conclusions A single position after XLIF surgery is a feasible modification to the standard procedure when used with fluoroscopy and a guide wire-less PPS system. The time saved is the main advantage of inserting the PPS with the patient in the lateral decubitus position without repositioning. Use of the lateral PPS with a guide wire-less technique may help improve operative efficiency and reduce cost.

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Section: Discussionmentioning

confidence: 99%

The analysis of percutaneous pedicle screw technique with guide wire-less in lateral decubitus position following extreme lateral interbody fusion

Hiyama¹,

Sakai²,

Sato³

et al. 2019

J Orthop Surg Res

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“…Due to an aging population and the needs of patients with spinal disorders, various minimally invasive surgery (MIS) techniques are gaining popularity. In particular, procedures that use percutaneous pedicle screws (PPSs) are practiced widely, such as MIS-transforaminal lumbar interbody fusion (TLIF) and MIS long fixation [1][2][3][4].…”

Section: Introductionmentioning

confidence: 99%

Contraindication of Minimally Invasive Lateral Interbody Fusion for Percutaneous Reduction of Degenerative Spondylolisthesis: A New Radiographic Indicator of Bony Lateral Recess Stenosis Using I Line

et al. 2021

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This study aimed to evaluate aggravated lateral recess stenosis and clarify the indirect decompression threshold by combined lateral interbody fusion and percutaneous pedicle screw fixation (LIF/PPS). Overview of Literature: No previous reports have described an effective radiographic indicator for determining the surgical indication for LIF/PPS. Methods: A retrospective review of 185 consecutive patients, who underwent 1-or 2-level lumbar fusion surgery for degenerative spondylolisthesis (DS). According to their symptomatic improvement, they were placed into either the "recovery" or "no-recovery" group. Preoperative computed tomography (CT) images were evaluated for the position of the superior articular processes at the slipping level, followed by a graded classification (grades 0-3) using the impingement line (I line), a new radiographic indicator. All 432 superior articular facets in 216 slipped levels were classified, and both groups' characteristics were compared. Results: There were 171 patients (92.4%) in the recovery group and 14 patients in the no-recovery group (7.6%). All patients in the no-recovery group were diagnosed with symptoms associated with deteriorated bony lateral recess stenosis. All superior articular processes of the lower vertebral body in affected levels reached and exceeded the I line (I line-; grade 2 and 3) on preoperative sagittal CT images. In the recovery group, most superior articular processes did not reach the I line (I line+; grade 0 and 1; p=0.0233). Conclusions: In DS cases that are classified as grade 2 or greater, the risk of aggravated bony lateral recess stenosis due to corrective surgery is high; therefore, indirect decompression by LIF/PPS is, in principle, contraindicated.

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“…The percutaneous pedicle screw placement had significant potential limitations as well. These limitations included [1,3,10,20]: longer operation time and greater fluoroscopy frequencies for both medical staffs and the patients. The traditional percutaneous methods showed a high incidence of erroneous placement [21] of the pedicle screws and a steep learning curve [22].…”

Section: Resultsmentioning

confidence: 99%

“…During the traditional percutaneous procedures [6][7][8], visualization of the bony landmarks depends heavily on fluoroscopic guidance [3,9], which could result in significant levels of radiation exposure to both the surgeon and assistant [7,10]. An efficient instrument or system that allows for accurate pedicle screw placement and a reduction in the fluoroscopic time would therefore be of value [1,4,11]. In this article, a novel hand-held retractor was designed to help exposing the spinal anatomical landmarks.…”

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confidence: 99%

A novel retractor for reducing operation time and radiation exposure in percutaneous pedicle screw placement

Niu¹,

He²,

Duan³

et al. 2020

Turkish Neurosurgery

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Background : Percutaneous pedicle screw fixation is less damage to the surrounding musculature and can decrease both blood loss and recovery time, but depends heavily on fluoroscopic guidance. An efficient instrument or system that allows for accurate pedicle screw placement and reduction in the fluoroscopy shot time would therefore be of value. Methods: 126 patients with single segment thoracolumbar vertebral fracture were surgically treated with percutaneous pedicle screws through our novel retractor technique group A or traditional fluoroscopic method(group B), the operation time and fluoroscopy shot times were compared, and the accuracy of screw placement were assessed. Results : There was no serious complications occurring during our study, such as infection, blood vessel injury, spinal cord or nerve root injury. We did not find any statistically difference between the two groups in corrected rate of regional Cobb's angle or vertebral body height percentage(P>0.05); however, the mean operation time was found to be 75.9±2.37min in the novel retractor method group and 94.2±2.19min in the traditional method group. The difference was statistically significant (p 0.001). Fluoroscopy shot times averaged 9.01±0.41 in the novel retractor group versus 16.8±0.56 in the traditional group (P < 0.001), the novel retractor group had apparent advantages over the traditional method in postoperative improvement on visual analog scale (VAS) scores and Oswestry Disability Index (ODI) at 2days, 3month after operation and last follow-up (P<0.05). There was no statistical difference between the novel retractor group and traditional method group in the radiographic results and screw position violation grade. Conclusion: The novel retractor method had several advantages, including shorter operation time, less fluoroscopy shot times, and better postoperative improvement on visual analog scale(VAS) score and Oswestry Disability Index (ODI). It provides a new alternative method for effective management of thoracolumbar fractures. Background: Percutaneous pedicle screw fixation offer a less traumatic approach resulting in less damage to the surrounding musculature and a decrease in both blood loss and recovery time[1-5]. These

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A Novel Percutaneous Guide Wire (S-Wire) for Percutaneous Pedicle Screw Insertion

Cited by 13 publications

References 14 publications

The analysis of percutaneous pedicle screw technique with guide wire-less in lateral decubitus position following extreme lateral interbody fusion

The analysis of percutaneous pedicle screw technique with guide wire-less in lateral decubitus position following extreme lateral interbody fusion

Contraindication of Minimally Invasive Lateral Interbody Fusion for Percutaneous Reduction of Degenerative Spondylolisthesis: A New Radiographic Indicator of Bony Lateral Recess Stenosis Using I Line

A novel retractor for reducing operation time and radiation exposure in percutaneous pedicle screw placement

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