Prospective comparative study between straight and curved probe for pedicle screw insertion

Pithwa, Yogesh Kishorkant; Venkatesh, Kumar

doi:10.1007/s00586-014-3310-2

Cited by 4 publications

(8 citation statements)

References 11 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…A spinal burr or awl could also have been used as an alternative, as is described in the veterinary and human literature. 12,31 In clinical cases, loss of the cis cortex associated with use of a spinal burr may not be of structural concern as the polymethylmethacrylate will support this outer cortical defect. In our study, a 2-mm drill bit was used instead of a burr as it avoided this loss of cis cortex.…”

Section: Discussionmentioning

confidence: 99%

“…A limitation of that report 5 is that postoperative CT was not performed, which has been shown to be significantly more accurate in identifying canal violation compared with conventional radiography 27 . In people, the pedicle‐probing technique is associated with a high degree of accuracy in several studies, even in cases of spine deformities 25,28–31 . Five studies 25,28–30,32 that included a total of almost 600 patients undergoing posterior stabilization with transpedicular screws reported medial pedicle wall violation rates of 0.5%–6.3%, with only one screw requiring repositioning and none associated with neurological or visceral complications.…”

Section: Discussionmentioning

confidence: 99%

“…27 In people, the pedicle-probing technique is associated with a high degree of accuracy in several studies, even in cases of spine deformities. 25,[28][29][30][31] Five studies 25,[28][29][30]32 that included a total of almost 600 patients undergoing posterior stabilization with transpedicular screws reported medial pedicle wall violation rates of 0.5%-6.3%, with only one screw requiring repositioning and none associated with neurological or visceral complications. The medial cortex of the thoracic pedicle has been shown to be thicker than the lateral cortex in humans, [33][34][35] a factor that may contribute to a decreased rate of medial cortex breach with the pedicleprobing technique in people.…”

Section: Discussionmentioning

confidence: 99%

“…In people, straight and curved pedicle probes/awls are commercially available but are generally larger than would be appropriate for canines because of the relatively larger size of the pedicle in people. 31,36,37 In recent years, probes with an electrical impedance conductivitymeasuring device have been developed to improve accuracy of pedicle screw placement in people. 37,38 By monitoring electrical conductivity in surrounding tissues, these probes can alert the surgeon to an impending breach.…”

Section: Discussionmentioning

confidence: 99%

“…Creation of the cortical defect (decortication) was performed with a 2‐mm drill bit in our study. A spinal burr or awl could also have been used as an alternative, as is described in the veterinary and human literature 12,31 . In clinical cases, loss of the cis cortex associated with use of a spinal burr may not be of structural concern as the polymethylmethacrylate will support this outer cortical defect.…”

Section: Discussionmentioning

confidence: 99%

See 4 more Smart Citations

Accuracy of pin placement in the canine thoracolumbar spine using a free‐hand probing technique versus 3D‐printed patient‐specific drill guides: An ex‐vivo study

et al. 2023

View full text Add to dashboard Cite

Objective To compare pin placement accuracy, intraoperative technique deviations, and duration of pin placement for pins placed by free‐hand probing (FHP) or 3D‐printed drill guide (3DPG) technique. Sample population Four greyhound cadavers. Methods Computed tomography (CT) examinations from T6‐sacrum were obtained for determination of optimal pin placement and 3DPG creation. Two 3.2/2.4‐mm positive profile pins were inserted per vertebra, one left and one right from T7–L7 (FHP [n = 56]; 3DPG [n = 56]) by one surgeon and removed for repeat CT. Duration of pin placement and intraoperative deviations (unanticipated deviations from planned technique) were recorded. Pin tracts were graded by two blinded observers using modified Zdichavsky classification. Descriptive statistics were used. Results A total of 54/56 pins placed with 3DPGs were assigned grade I (optimal placement) compared with 49/56 pins using the FHP technique. A total of 2/56 pins placed with 3DPGs and 3/56 pins using the FHP technique were assigned grade IIa (partial medial violation). A total of 4/56 pins placed using the FHP technique were assigned grade IIIa (partial lateral violation). No pins were assigned grade IIb (full medial violation). Intraoperative technique deviations occurred with 6/56 pins placed using the FHP technique and no pins with 3DPGs. Overall, pins were placed faster (mean ± SD 2.6 [1.3] vs. 4.5 [1.8] min) with 3DPGs. Conclusions Both techniques were accurate for placement of spinal fixation pins. The 3DPG technique may decrease intraoperative deviations and duration of pin placement. Clinical relevance Both techniques allow accurate pin placement in the canine thoracolumbar spine. The FHP technique requires specific training and has learning curve, whereas 3DPG technique requires specific software and 3D printers.

show abstract

Section: Discussionmentioning

confidence: 99%