Comparative analysis of the accuracy of pedicle screws insertion in surgical treatment of children with idiopathic scoliosis

Кокушин, Дмитрий Николаевич; Белянчиков, Сергей Михайлович; Murashko, Vladislav; Картавенко, Кирилл Александрович; Khusainov, N.O.

doi:10.14531/ss2017.4.8-17

Cited by 3 publications

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“…Gertzbein et al, где Grade 0 (full correct) -ТВ полностью находится в корне дуги, Grade I -смещение ТВ относительно кортикального слоя корня дуги до 2 мм, Grade II -смещение в пределах от 2 до 4 мм, Grade III -более 4 мм [23]. Для определения пространственного вида мальпозиции ТВ использовали схему SLIM + V: S (superior) -верхняя (краниальная) стенка корня дуги, L (lateral)латеральная (наружная) стенка корня дуги, I (inferior) -нижняя (каудальная) стенка корня дуги, M (medial) -медиальная (внутренняя) стенка корня дуги, V (vertebral body) -переднебоковая поверхность тела позвонка [24].…”

Section: материалы и методыunclassified

The use of guide templates in the surgical treatment of preschool children with congenital scoliosis of thoracic and lumbar localization

Kokushin

Николаевич²,

Vissarionov

et al. 2020

Pediatr Traum Orthop Reconstr Surg

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Background. The use of transpedicular screws as support elements from the standpoint of biomechanics is preferable as compared to that of laminar fixation, albeit the former carries the risk of various complications (such as malposition screws, damage to the Dura mater, spinal cord, and major blood vessels) caused by structural changes in the vertebrae under the background of their defects, with small size of roots arcs vertebrae in young children. Thus, the issue of ensuring safe and correct installation of transpedicular screws in the surgical treatment of children with congenital scoliosis remains relevant. Aim. We aimed to evaluate the correctness of the position of the transpedicular screws installed in the vertebral bodies in preschool children with congenital scoliosis of thoracic and lumbar localization using guide templates (SHN). Materials and methods. We conducted a prospective analysis of the outcomes of surgical treatment of 30 patients with congenital scoliosis against the background of impaired formation of the vertebrae of the thoracic and lumbar spine. The patients included 12 boys and 18 girls of age: 1 year 8 months to 6 years 5 months (average: 3 years 4 months). Based on the computed tomography of the spine, performed postoperatively, the correctness of the position of the installed elements of the corrective multi-support metal structure was evaluated. The correctness of the position of the installed transpedicular support elements was evaluated based on the scale described by S.D. Gertzbein and co-authors (1990). Results. The total number of implanted transpedicular screws sets was 96 (100% of the planned transpedicular screws set), and 48 SHN were used for transpedicular screws installation. The correct position of installed screws by degree of displacement revealed Grade 0 93.7% (90 screws), Grade I 4.2% (4 screws), Grade II 2.1% (2 screws), Grade III 0%. The number of screws with a Grade 0 + Grade I offset was 94 (97.9%). Conclusion. The results obtained with the use of SHN among preschool children with congenital scoliosis of thoracic and lumbar localization revealed high accuracy and correctness of transpedicular screws installation (93.7%) with the use of this type of navigation in clinical practice. The use of SHN for installing transpedicular screws in the surgical treatment of congenital spinal deformities in young patients allows for the selection of the optimal size and correct position of the transpedicular support elements in the vertebrae to be instrumented.

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Section: материалы и методыunclassified

The use of guide templates in the surgical treatment of preschool children with congenital scoliosis of thoracic and lumbar localization

Kokushin

Николаевич²,

Vissarionov

et al. 2020

Pediatr Traum Orthop Reconstr Surg

Self Cite

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“…-Grade III -более 4 мм [14]. Для проведения сравнительного анализа корректности положения Тв, установленных в позвонки in vivo при помощи метода «свободной руки» и в пластиковые модели позвонков in vitro при помощи Шн, использовали схему SlIM+V.…”

Section: материал и методыunclassified

Comparative Analysis of Pedicle Screw Placement in Children with Congenital Scoliosis: Freehand Technique <i>(in vivo)<i> and Guide Templates <i>(in vitro)<i>

Kokushin

Vissarionov

Баиндурашвили

et al. 2018

Traumatology and Orthopedics of Russia

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Objective.To evaluate accuracy between pedicle screw placement in vertebral bodies achieved in vivo with freehand techniques versus their placement in vertebrae plastic models achieved in vitro with the use of guide templates, in toddlers and preschool children with congenital kyphoscoliosis of the thoracolumbar transition and lumbar spine amid the vertebral malformation.Material and Methods. The research is based on a retrospective analysis of the results of treatment of 10 patients with congenital kyphoscoliosis of the thoracolumbar transition and lumbar spine amid the vertebral malformation. Age – from 2 years 2 months to 6 years 8 months old (mean 3 years 8 months old), gender – 6 boys, 4 girls. Based on the postoperative multi-slice spiral computed tomography (MSCT) of the spine, the pedicle screws placement accuracy of the correcting multi-support metalwork was evaluated. These patients constituted the 1st research group (in vivo group). The 2nd research group (in vitro group) was formed from 27 vertebrae plastic models with pedicle screws inserted in them with the use of guide templates. The placement accuracy of the installed pedicle support elements was assessed based on the S.D. Gertzbein et al. scale (1990).Results. In the 1st group, there were 52 pedicle screws placed. The screw placement accuracy according to the rate of misplacement, as follows: 53.8% in Grade 0, 25% in Grade I, 11.6% in Grade II, 9.6% in Grade III. The number of screws with the rate of misplacement in Grade 0 + Grade I was 41 (78.8%). In the 2nd group, there were 54 screws placed and slightly larger than the 1st group. The screw placement accuracy according to the rate of misplacement was 94.4% in Grade 0, 1.9% in Grade I, 3.7% in Grade II, respectively. The number of screws with the rate of misplacement in Grade 0 + Grade I was 52 (96.3%).Conclusions.Comparative analysis showed that the number of pedicle screws successfully placed in vertebrae plastic models in children with congenital deformities of the thoracolumbar transition and lumbar spine achieved with the use of guide templates was significantly higher than the number of screws successfully placed with freehand techniques (96.3% versus 80.8%, p = 0.011). The results obtained with method of navigation templates in vitro showed high precision and accuracy of pedicle screw placement which gives the prospect for using this type of navigation in clinical practice in toddlers with congenital scoliosis.

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Comparing the Treatment of Congenital Spine Deformity Using Freehand Techniques In Vivo and 3D-Printed Templates In Vitro (Prospective–Retrospective Single-Center Analytical Single-Cohort Study)

et al. 2019

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Comparative analysis of the accuracy of pedicle screws insertion in surgical treatment of children with idiopathic scoliosis

Cited by 3 publications

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The use of guide templates in the surgical treatment of preschool children with congenital scoliosis of thoracic and lumbar localization

The use of guide templates in the surgical treatment of preschool children with congenital scoliosis of thoracic and lumbar localization

Comparative Analysis of Pedicle Screw Placement in Children with Congenital Scoliosis: Freehand Technique <i>(in vivo)<i> and Guide Templates <i>(in vitro)<i>

Comparing the Treatment of Congenital Spine Deformity Using Freehand Techniques In Vivo and 3D-Printed Templates In Vitro (Prospective–Retrospective Single-Center Analytical Single-Cohort Study)

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