Perkutane dorsale versus offene Instrumentation bei Frakturen des thorakolumbalen Übergangs

Grass, R.; Biewener, A.; Dickopf, A.; Rammelt, S.; Heineck, J.; Zwipp, H.

doi:10.1007/s00113-005-1037-6

Cited by 66 publications

(24 citation statements)

References 19 publications

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“…However Grass et al [11] found no significant difference in operation time, radiation time and accuracy of screw placement. In our own clinical experience and in the present study we found indeed longer radiation times within the percutaneous group.…”

Section: Discussionmentioning

confidence: 94%

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Comparison of open versus percutaneous pedicle screw insertion in a sheep model

et al. 2008

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Minimally invasive surgery has become more and more important for the treatment of traumatic spine fractures. Besides, some clinical studies, objective data regarding the possible lower damage to the surrounding tissue of the spine is still missing. Here we report a sheep model where we compared a percutaneous versus an open approach for dorsal instrumentation with pedicle screws to the spine. Twelve skeletally mature sheep underwent bilateral pedicle screw fixation at the L4-L6 level. Fortyeight pedicle screws were bilaterally inserted into the pedicles and connected with rods using either an open dorsal standard or a percutaneous approach. Operation time, blood flow, compartment pressure, radiation time, loss of blood, laboratory findings and EMG were evaluated to objectify possible advantages for the percutaneous operation technique. Loss of blood and the distribution of CK-MM as a marker for muscle damage were significantly lower in the percutaneous group. However, radiation time was significantly longer in the percutaneous group. Other parameters like compartment pressure, blood flow and also measurement of the EMG at different time points did not reveal significant differences. Based on the results we found in the present study, percutaneous screw insertion can bring moderate advantages but it should be noted that essential functional deficits to the muscle could not be detected.

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Section: Discussionmentioning

confidence: 94%

“…Herewith tissue dissection, blood loss and hospitalisation should be reduced. This raises hope that the treatment of patients can be improved and some promising results have been published [8,11,21,26]. A derivative design of the percutaneously inserted spinal fixation systems that are available has already improved the surgical technique.…”

Section: Introductionmentioning

confidence: 99%

Comparison of open versus percutaneous pedicle screw insertion in a sheep model

et al. 2008

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“…Using this technique, significant reduction of blood loss was achieved. Grass et al [8] showed an average blood loss of 43 ml (10-90 ml) versus the open approach needing 870 ml (570-1,200 ml). A faster rehabilitation due to the less invasive technique has been described by different current publications [3,5,6,22].…”

Section: Introductionmentioning

confidence: 99%

“…Although percutaneous posterior instrumentation has been described in several clinical studies [1,4,11,13,15,17,18,23,24], there is lack of data in the literature concerning their use in thoracic and lumbar spine fractures. Traditional open thoracolumbar instrumentation results in significant iatrogenic damage of the vital dorsal musculoligamentous complex [8,10,19,21].…”

Section: Introductionmentioning

confidence: 99%

Accuracy of percutaneous pedicle screws for thoracic and lumbar spine fractures: a prospective trial

Heintel¹,

Berglehner²,

Meffert³

2012

Eur Spine J

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Purpose The percutaneous insertion technique requires surgical skill and experience. However, there have been few clinical reports evaluating the accuracy of minimally invasive pedicle screw placement using the conventional fluoroscopy method. The purpose of this study was to evaluate the accuracy of percutaneous pedicle screw placement in the treatment of thoracic and lumbar spine fractures using two-plane conventional fluoroscopy. Methods A prospective clinical trial was performed. A total of 502 percutaneous pedicle screws in 111 patients, all inserted with the assistance of conventional fluoroscopy, were evaluated. The safety and accuracy of pedicle screw placement were based on the evaluation of postoperative axial 3-mm slice computed tomography scans using the scoring system described by Zdichavsky et al. [Eur J Trauma 30:234-240, 2004; Eur J Trauma 30:241-247, 2004]. Results 427/502 pedicle screws (85 %) were classified as good and excellent concerning the best possible screw length and 494/502 (98 %) were found to have good or excellent position. One screw had to be revised due to medial position with a neurological deficit. Conclusions This study demonstrates the feasibility of placing percutaneous posterior thoracolumbar pedicle screws with the assistance of conventional fluoroscopy. Minimally invasive transpedicular instrumentation is an accurate, reliable and safe method to treat a variety of spinal disorders, including thoracic and lumbar spine fractures.

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“…1,2) PPSs are usually inserted using a mobile fluoroscope, such as a C-arm. Recently, surgical support devices used when inserting pedicle screws have been undergoing rapid development, and performing more accurate and minimally invasive surgery has become possible by (i) combining a navigation system with a mobile fluoroscope that can acquire three-dimensional images, such as the Arcadis Orbic Isocentric C-arm (Siemens Healthcare, Germany) 3,4) or the O-arm (Medronic, USA), 5–7) or (ii) combining a navigation system with a Computed tomography (CT) device 8,9) or the mobile CT device Airo (Brainlab AG, Germany).…”

Section: Introductionmentioning

confidence: 99%

Advantages and Disadvantages of Multi-axis Intraoperative Angiography Unit for Percutaneous Pedicle Screw Placement in the Lumbar Spine

Kageyama

Yoshimura

Uchida

et al. 2017

Neurol. Med. Chir.(Tokyo)

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We analyzed clinical usefulness of the high resolution imaging system in a hybrid operation room (OR) for posterior lumbar interbody fusion. A total of 17 patients with lumbar spondylolisthesis between February 2014 and August 2016 were included. Multi-axis imaging system in a hybrid OR was used in 12 patients (hybrid OR group); the conventional C-arm fluoroscopy, in 5 patients (C-arm group). The time to confirm the first percutaneous pedicle screw (PPS) angle (hybrid OR, 80 vs C-arm, 249 s; P = 0.0026) and the second to the last PPS angle (77 vs 90 s; P = 0.040) were shorter in the hybrid OR group. Placement accuracy was higher in the hybrid OR group (88.0 vs 59.1%; P = 0.010). Irradiation dose was significantly lower in the C-arm group (462 vs 102 mGy; P = 0.0013). This study suggested that the accuracy of PPS placement and time to confirm the PPS angle are the advantages in a hybrid OR.

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Perkutane dorsale versus offene Instrumentation bei Frakturen des thorakolumbalen Übergangs

Cited by 66 publications

References 19 publications

Comparison of open versus percutaneous pedicle screw insertion in a sheep model

Comparison of open versus percutaneous pedicle screw insertion in a sheep model

Accuracy of percutaneous pedicle screws for thoracic and lumbar spine fractures: a prospective trial

Advantages and Disadvantages of Multi-axis Intraoperative Angiography Unit for Percutaneous Pedicle Screw Placement in the Lumbar Spine

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