Intraoperative computed tomography with integrated navigation in percutaneous iliosacral screwing

Peng, Kuo Ti; Li, Yen Yao; Hsu, Wei Hsiu; Wu, Meng; Yang, Jing‐Tang; Hsu, Chu Hsiang; Huang, Tiao‐Lai

doi:10.1016/j.injury.2012.09.017

Cited by 41 publications

(20 citation statements)

References 20 publications

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“…Some experts report that the optimal angle of the inlet and outlet views is when some anatomic landmarks become radiodense 27 . Recently, CT fluoroscopy and computer-assisted navigation have been evaluated to improve the accuracy of screw positioning, which is available in most institutions 28 , 29 . Moreover, screw malpositioning with injury to local neurovascular structures reportedly occurs in 2–15% of cases, even by experienced surgeons 6 , 9 , 10 .…”

Section: Discussionmentioning

confidence: 99%

Percutaneous Placement of Iliosacral Screws Under the Guidance of Axial View Projection of the S1 Pedicle: a Case Series

Yin

Hou

Zhang

et al. 2017

Sci Rep

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The aim of this study was to evaluate the safety and efficacy of percutaneous placement of iliosacral screws under the guidance of axial view projection of the S1 pedicle clinically. This case series includes 58 consecutive unstable pelvic injury patients, which were treated with iliosacral screws between July 2011 and July 2016. Patients were divided into two groups: normal sacrum (n = 31) and dysmorphic sacrum (n = 27). A single orthopedic surgeon operated on all patients, with percutaneous placement of iliosacral screws under the guidance of axial view projection of the S1 pedicle. The time needed for screw insertion and the radiation exposure time were recorded. Chi-squared test and Student t-test were used to analyze the differences between the two groups. Sacral dysmorphism was present in 47% of patients. The median time for screw insertion and radiation exposure time in these two groups showed no statistical difference (P > 0.05). No clinical complications or malpositioned screws occurred in any case. Preoperative pelvic CT is necessary to determine the sacral osseous anatomy. In patients with either a normal or dysmorphic sacrum, iliosacral screws can be placed by this method with less radiation exposure and complications than in the conventional method.

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Section: Discussionmentioning

confidence: 99%

Percutaneous Placement of Iliosacral Screws Under the Guidance of Axial View Projection of the S1 Pedicle: a Case Series

Yin

Hou

Zhang

et al. 2017

Sci Rep

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“…Thus, the authors concluded it was a feasible technique. In 2012, Peng et al [9] analyzed an iliosacral screw integrated navigation system with CT scanning in patients (n=13) who presented with pelvic fractures with posterior ring disruption. The authors found high accuracy, defined as lack of penetration or encroachment of a foramen/nerve or the spinal cord, with no injuries in any of the 13 cases.…”

Section: Discussionmentioning

confidence: 99%

“…Box 112727, Gainesville, Florida 32601, Tel: 352-273-7434; Fax: 352 273 7388; E-mail: macmim@ortho.ufl.edu trajectory due to obesity, bowel gas, or contrast media and the level of technical skills required [2,3]. Computed tomography (CT) scans present a less technically demanding option for trajectory mapping and have been studied extensively [3][4][5][6][7][8][9][10].…”

Section: Introductionmentioning

confidence: 99%

Feasibility of Merging Sacroiliac Fusion Computed Tomography Preoperative Planning to Original Computed Tomography Scans

Alvin

Yang²,

MacMillan³

2013

TOSPINEJ

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Background: Spinal merging has been done with preoperative CT scans merged with fluoroscopic imaging. However, preoperative and intraoperative CT scans have not been merged for the purposes of transferring a plan. If spine surgeons can create the optimal surgical pathway before surgery and then merge the pre-planned pathway onto the real patient CT scan in the operating room, the result will be efficiency and better time management for the spine surgeon. Our objective was to analyze the feasibility of merging computed tomography (CT) preplanned with sacroiliac fusion iliosacral screw trajectories with the original CT scans. Methods: Twenty-seven patients were identified from the institutional Faculty Group Practice who had undergone CT scans in the pelvic region. The pelvic CT scans were transferred to Medtronic's StealthStation ® , which allowed for analysis in coronal, sagittal, and axial sections. Three trajectories were mapped out, representing three working pathways for fixation. The position of the trajectories was localized by measuring their distance from anatomic landmarks. The CT scan with the planned trajectories was merged with the original CT scan. The same measurements made pre-merge were performed post-merge to check for the accuracy of the merging process. Results: Post-merge measurements were nearly identical to pre-merge measurements, with a maximum difference of ± 0.1 mm. No significant differences existed between pre-merge and post-merge measurements for any of the trajectories Conclusion: The merging of preplanned trajectory CT scans with intraoperative CT scans is a highly accurate technique. Clinical relevance: If this technique can be replicated by merging actual pre-operative CT scans with actual intraoperative scans, it could save time and expense. This would benefit the patient because time under anesthesia would be reduced.

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“…Fixierte Systeme werden meist auf einem Schienensystem (sliding gantry) fixiert und können somit im Operationssaal bewegt werden. Der CT kann zusätzlich mit einem Navigationssystem kombiniert werden, um eine hohe Präzision zu ermöglichen [15]. Seit Kurzem stehen auch mobile CT-Scanner zur Verfügung [16,17].…”

Section: Intraoperative Computertomografieunclassified

Intraoperative Bildgebung in der Beckenchirurgie

Richter¹,

Eickhoff²,

Gebhard³

et al. 2018

OP-JOURNAL

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ZusammenfassungDer rasante technische Fortschritt der letzten Jahre führte auch zu einer Weiterentwicklung moderner intraoperativer Bildgebungssysteme. Diese werden entweder als fixierte oder mobile Systeme angeboten und führen zu einer deutlichen Verbesserung der Bildqualität und Vergrößerung des Bilddurchmessers. Hier steht vor allem die Flachdetektor-Technologie im Vordergrund. Viele dieser Systeme bieten die Möglichkeit der intraoperativen 3-D-Darstellung. Fehllagen oder ungenügende Repositionen können dadurch in der gleichen Operation korrigiert werden, um Folgeoperationen zu vermeiden. Im Bereich des Beckens führt die Nutzung moderner Bildgebungssysteme in Kombination mit Navigationssystemen zu einer verbesserten Präzision der Implantatlage.

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Intraoperative computed tomography with integrated navigation in percutaneous iliosacral screwing

Cited by 41 publications

References 20 publications

Percutaneous Placement of Iliosacral Screws Under the Guidance of Axial View Projection of the S1 Pedicle: a Case Series

Percutaneous Placement of Iliosacral Screws Under the Guidance of Axial View Projection of the S1 Pedicle: a Case Series

Feasibility of Merging Sacroiliac Fusion Computed Tomography Preoperative Planning to Original Computed Tomography Scans

Intraoperative Bildgebung in der Beckenchirurgie

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