Percutaneous Iliosacral Screw Placement Using Image Guided Techniques

Tonetti, Jérôme; Carrat, Lionel; Lavallée, Stéphane; Pittet, L.; Merloz, P.; Chirossel, J. P.

doi:10.1097/00003086-199809000-00013

Cited by 112 publications

(57 citation statements)

References 6 publications

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“…Accuracy of computer-guided transiliosacral screw implantation has been reported to be sufficiently effective and safe in preclinical work [4,31] to warrant clinical trials. One cadaver study comparing fluoroscopic and computer-assisted surgery reported two of 10 screws penetrated the cortex equally in both groups [8].…”

Section: Discussionmentioning

confidence: 99%

“…Treatment of unstable pelvic ring fractures by transiliosacral screw fixation after accurate reduction has gained general acceptance to rigidly stabilize pelvic fractures and posterior sacroiliac ligamentous injuries [6,13,15,16,19,20,22,31]. Use of a percutaneous method avoids the high rate of wound necrosis and infection associated with open procedures [15,19].…”

Section: Introductionmentioning

confidence: 99%

“…Routt et al [19] described the advantages of this approach, particularly decreased blood loss and lower risk of infection [19]. To achieve proper screw fixation, various authors have used fluoroscopy [9,20], computed tomography (CT) [9,12,17], fluoroscopic CT, and computer-assisted techniques [4,11,31]. Conventional fluoroscopy is the current standard for intraoperative observation [6,12,13,15,19,20].…”

Section: Introductionmentioning

confidence: 99%

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Computer-navigated Iliosacral Screw Insertion Reduces Malposition Rate and Radiation Exposure

Zwingmann¹,

Konrad²,

Kotter³

et al. 2009

Clinical Orthopaedics &Amp; Related Research

146

110

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Insertion of percutaneous iliosacral screws with fluoroscopic guidance is associated with a relatively high screw malposition rate and long radiation exposure. We asked whether radiation exposure was reduced and screw position improved in patients having percutaneous iliosacral screw insertion using computer-assisted navigation compared with patients having conventional fluoroscopic screw placement. We inserted 26 screws in 24 patients using the navigation system and 35 screws in 32 patients using the conventional fluoroscopic technique. Two subgroups were analyzed, one in which only one iliosacral screw was placed and another with additional use of an external fixator. We determined screw positions by computed tomography and compared operation time, radiation exposure, and screw position. We observed no difference in operative times. Radiation exposure was reduced for the patients and operating room personnel with computer assistance. The postoperative computed tomography scan showed better screw position and fewer malpositioned screws in the three-dimensional navigated groups. Computer navigation reduced malposition rate and radiation exposure. Level of Evidence: Level II, therapeutic study. See the Guidelines for Authors for a complete description of levels of evidence.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Computer-navigated Iliosacral Screw Insertion Reduces Malposition Rate and Radiation Exposure

Zwingmann¹,

Konrad²,

Kotter³

et al. 2009

Clinical Orthopaedics &Amp; Related Research

146

110

View full text Add to dashboard Cite

show abstract

“…A procedure of special interest to our group is the transiliac screw insertion for traumatic or degenerative disorders of the sacroiliac joint [8,18,25]. The procedure is technically demanding and is at present either fluoroscopic guided or computer assisted using C-arm or CT-based navigation [12,17,28,31].…”

mentioning

confidence: 99%

Computer-assisted screw insertion into the first sacral vertebra using a three-dimensional image intensifier: results of a controlled experimental investigation

et al. 2005

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“…This method was compared to a standard surface-based registration for accuracy of screw placement, although only a qualitative measure was provided, noting success in 12 of 12 cases. 11 Tracked, free-hand 3D US has also been studied in a phantom model at the University of Washington for use in image-guided neurosurgery. A point-based algorithm was used to register US and MR images from a custom-made phantom.…”

Section: Introductionmentioning

confidence: 99%

Three-dimensional image registration of phantom vertebrae for image-guided surgery: A preliminary study

Muratore

Russ

Dawant

et al. 2002

Comput. Aided Surg.

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of Biomedical Engineering (D.iV1.M.) Westem New Englnnd CoIIege, Sp?in&eki, iMassacbzlsetts ABSTRACT Objective: Applications of three-dimensional ultrasound (3D US) are emerging throughout the field of medicine. In this study, tracked, fi-ee-hand 3D phantom US images were mapped to computed tomograms (CT) as a development for image-guided surgery (IGS) of the spine. In the operating room, the registration of tracked 3D US images to other imaging modalities, such as CT, could allow the surgeon to identlfy more precisely the surgical target area prior to the incision. An independent quantitative measure of registration accuracy using a fiducial marker system was provided.Methods: Three-dimensional free-hand US images of a phantom spine were created by tracking the transducer with an optical sensing system. Two sets of images were acquired from three lumbar vertebrae using 4.5-and 7.5-hmz transducers. These images were then segmented for the extraction of the posterior vertebral surface. Next, a surface-based registration of US to the corresponding segmented CT images was performed. Registration errors were computed as the distance between a set of target points transformed using the experimental transformation and the same set of target points transformed using fiducial markers as a gold standard.Results: Results indicated that alignment of these image sets is feasible using only part of the vertebral surface. In particular, the regions of the spinous process and laminae were used for registration.Target registration errors (IRES) were found to be lowest using the highest resolution CT images.Using the CT scans with 2-mm slice thickness, the TRE was calculated to be 1.33 k 0.30 mm for the 7.5-MHz US data set and 2.81 f . 0.10 mm for the 4.5-MHz US data set. Moreover, residual errors in these d c e alignments were 0.69 f 0.18 mm and 0.61 f . 0.20 mm for the 4.5-and 7.5-MHz sets, respectively. Conclusion: A rigid, surface-based registration of C T images to phantom spinal US images, acquired with a free-hand, tracked transducer, is achievable with a limited, easily obtainable portion of the vertebral surface. Comp Aid Surg 7:312-352 (2002). 02003 WiIey-Liss. Inc.

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Percutaneous Iliosacral Screw Placement Using Image Guided Techniques

Cited by 112 publications

References 6 publications

Computer-navigated Iliosacral Screw Insertion Reduces Malposition Rate and Radiation Exposure

Computer-navigated Iliosacral Screw Insertion Reduces Malposition Rate and Radiation Exposure

Computer-assisted screw insertion into the first sacral vertebra using a three-dimensional image intensifier: results of a controlled experimental investigation

Three-dimensional image registration of phantom vertebrae for image-guided surgery: A preliminary study

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