Safe Pedicle Screw Placement in Thoracic Scoliotic Curves Using t-EMG

Blas, Gema de; Barrios, Carlos; Regidor, Ignacio; Montes, Elena; Burgos, Jesús; Pizá-Vallespir, Gabriel; Hevia, Eduardo

doi:10.1097/brs.0b013e31823b077b

Cited by 28 publications

(11 citation statements)

References 25 publications

(20 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Использование детальной визуализации задних структур и точек имплантации в сочетании с методом freehand под ЭМГ-контролем повышает точность установки винтов до 98 % [17,18]. Достаточно надежным способом формирования корректного транспедикулярного канала является развертка PediGuard (ECD), принцип действия которой основан на импедансометрии, что существенно снижает риск опасных мальпозиций.…”

Section: Discussionunclassified

Analysis of the 3D prototyping in the surgical correction of congenital kyphoscoliosis

et al. 2020

View full text Add to dashboard Cite

Objective. To analyze the advantages of additive technologies and 3D modeling in surgery for severe congenital spinal deformities caused by mixed and non-classified developmental anomalies, including assessing the quality of transpedicular screws. Material and Methods. A total of 20 patients with complex spinal anatomy caused by congenital vertebral anomalies were treated. Nine patients had complex unclassifiable anomalies of the spine, 11 had mixed anomalies, 3 of them had aplasia of the structures of the spinal column. In order to assess the results, patients were divided into two groups of 10 people. In Group I, standard preoperative preparation was performed according to X-ray, CT and MRI data. In Group II, preoperative preparation was accompanied by the use of a prefabricated 3D model of the patient's spine. CT data were used to create STL-models which were printed using 3D printer. To analyze the effectiveness of 3D prototyping in preoperative planning, a survey among surgeons specializing in pathology of the spine was conducted. Results. Survey results demonstrated that there were cases of changes in surgical treatment tactics after the 2nd stage of the survey, based on the results of applying standard methods of radiation diagnostics and 3D model of the entire spine with prototyping of the thoracic, lumbar, and sacral spine. In 25.3 % of cases, tactics were changed. Significant improvement in surgical treatment results were observed in Group II with preoperative 3D modeling (94.9 % without screw malposition), compared to Group I in which surgical correction was performed using standard methods of imaging (78.1 % without screw malposition). Цель исследования. Анализ преимуществ аддитивных технологий и 3D-моделирования при хирургии тяжелых врожденных деформаций позвоночника, вызванных смешанными и неклассифицируемыми аномалиями развития, включая оценку качества проведения транспедикулярных винтов. Материал и методы. Проведено лечение 20 пациентов со сложной анатомией позвоночника, вызванной врожденными аномалиями развития позвонков. У 9 пациентов имелись сложные неклассифицируемые аномалии развития позвоночника, у 11-смешанные аномалии, у 3 из них-аплазия структур позвоночного столба. С целью оценки результатов пациентов разделили на две группы по 10 человек. В группе I проводили стандартную предоперационную подготовку по данным рентгенограмм, КТ и МРТ. В группе II предоперационная подготовка сопровождалась использованием предварительно изготовленной 3D-модели позвоночника пациента. За основу взяты данные КТ позвоночника, которые преобразовывали в stl-модель. Печать модели осуществляли с применением 3D-принтера. Провели анкетирование врачей, специализирующихся в патологии позвоночника, для оценки эффективности применения 3D-моделирования в предоперационном планировании. Результаты. При анкетировании хирургов отмечены случаи изменения тактики хирургического лечения после 2-го этапа опроса, основанные на применении стандартных методов лучевой диагностики и 3D-модели всего позвоночника пациента с прототипирова...

show abstract

Section: Discussionunclassified

Analysis of the 3D prototyping in the surgical correction of congenital kyphoscoliosis

et al. 2020

View full text Add to dashboard Cite

show abstract

“…Уста-новка винтов при ревизионных опе-рациях сопряжена с более высоким риском мальпозиций. Применение ЭМГ в качестве контроля при введении винтов признано ненадежным, так как обладает низкой чувствительно-стью, особенно на уровне Th 2 -Th 9 [8,31]. Однако использование детальной визуализации задних структур и точек имплантации в сочетании с методом freehand под ЭМГ-контролем повыша-ет точность установки винтов до 98 % [19].…”

Section: рисunclassified

Retrospective Analysis of Screw Malposition Following Instrumented Correction of Thoracic and Lumbar Spine Deformities

Губин¹,

Ryabykh²,

Burtsev³

2015

Hir. pozvonoč.

View full text Add to dashboard Cite

show abstract

“…It is also important to know that the[144045] threshold level that optimally classifies abnormal screws will vary depending on the location of the screw because the anatomy of the thoracic pedicles is different from that of the lumbar pedicles.…”

Section: Techniquesmentioning

confidence: 99%

A review of intraoperative monitoring for spinal surgery

Stecker¹

2012

Surg Neurol Int

102

View full text Add to dashboard Cite

Background:Intraoperative neurophysiologic monitoring (IONM) is a technique that is helpful for assessing the nervous system during spine surgery.Methods:This is a review of the field describing the basic mechanisms behind the techniques of IONM. These include the most often utilized trancranial motor evoked potentials (Tc-MEPs), somatosensory evoked potentials (SSEPs), and stimulated and spontaneous EMG activity. It also describes some of the issues regarding practices and qualifications of practitioners.Results:Although the anatomic pathways responsible for the Tc-MEP and SSEP are well known and these clinical techniques have a high sensitivity and specificity, there is little published data showing that monitoring actually leads to improved patient outcomes. It is evident that IONM has high utility when the risk of injury is high, but may be only marginally helpful when the risk of injury is very low. The monitoring team must be well trained, be able to provide the surgeon feedback in real time, and coordinate activities with those of the surgical and anesthesia teams.Conclusions:Although IONM is a valuable technique that provides sensitive and specific indications of neurologic injury, it does have limitations that must be understood. Maintaining a high quality of practice with appropriately trained personnel is critical.

show abstract

Safe Pedicle Screw Placement in Thoracic Scoliotic Curves Using t-EMG

Cited by 28 publications

References 25 publications

Analysis of the 3D prototyping in the surgical correction of congenital kyphoscoliosis

Analysis of the 3D prototyping in the surgical correction of congenital kyphoscoliosis

Retrospective Analysis of Screw Malposition Following Instrumented Correction of Thoracic and Lumbar Spine Deformities

A review of intraoperative monitoring for spinal surgery

Contact Info

Product

Resources

About