Technical Report of Free Hand Pedicle Screw Placement using the Entry Points with Junction of Proximal Edge of Transverse Process and Lamina in Lumbar Spine: Analysis of 2601 Consecutive Screws

Oh, Chang Hyun; Yoon, Seung Hwan; Kim, Yongjung J.; Hyun, Dong-Keun; Park, Hyeong-Chun

doi:10.14245/kjs.2013.10.1.7

Cited by 28 publications

(23 citation statements)

References 34 publications

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“…Oh CH [12]. No screw breach was de ned as grade 0; The screw breach distance away from the cortex less than 3mm was de ned as grade 1 (mild), 3-6mm as grade 2 (moderate), more than 6mm as grade 3…”

Section: Postoperative Accuracy Evaluation Of Screw Placementmentioning

confidence: 99%

The three-dimensional printed template guided technique for S2AI screw placement and a comparison with freehand technique

Zhou

Zeng

et al. 2020

Preprint

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Background Sacropelvic fixation continues to present challenges when involved in the adult spinal deformity correction. The S2 alar iliac (S2AI) fixation is commonly used in sacropelvic fixation. Several techniques, including intraoperative navigation and freehand technique, were used for S2AI screws placement. The aim of this study is to analyze the anatomic parameters for S2AI screw trajectory in Asian population and introduce a novel technique described as three-dimensional printed template guided technique (TGT). Meanwhile, the accuracy and safety of this technique were compared with conventional freehand technique. Methods The S2AI trajectory parameters were measured in100 Asian adult volunteers. Parameters were compared between different genders. Forty-eight adult patients who underwent S2AI screw placement were reviewed, 28 patients received freehand technique and 20 patients received TGT technique. Postoperative CT was used to assess the accuracy of screw trajectory and cortex violation related complications were recorded. Results The cephalocaudal angles (CA), maximal length of screw pathway (ML), narrowest width of pathway within the iliar teardrop (NW), distance from the center of teardrop to sciatic notch(SD) and distance of the start point distal to S1 dorsal foramen(DD) showed significant gender-related difference (p<0.05). All 48 patients were placed S2AI screws bilaterally (40 screws in TGT vs 56 screws in freehand). One screw penetrated iliac cortex in TGT group but 10 screws penetrated iliac cortex in freehand group (3% vs 17.9%) (p<0.05). Conclusion Approximately 30-35° of cephalocaudal angle and 39°mediolateral angle are appropriate for S2AI screw placement in Asian patients. Either freehand or TGT technique is safe for S2AI screw placement. TGT technique is more accurate compared with conventional freehand technique. Trial registration This is a retrospective study. Key words Sacropelvic fixation, Second sacral alar iliac (S2AI) screw, three-dimensional printed template, freehand technique

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Section: Postoperative Accuracy Evaluation Of Screw Placementmentioning

confidence: 99%

The three-dimensional printed template guided technique for S2AI screw placement and a comparison with freehand technique

Zhou

Zeng

et al. 2020

Preprint

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show abstract

“…Although many reports have proposed the optimal entry points for avoiding penetration of facet joints, these studies did not consider the technique of implantation and the degree of facet joint degeneration. [21][22][23] Hypertrophy and osteophytes of the facet joints are observed with aging and degenerative disease. Thus changes of the entry points and angulation angle in situ in cases of open approach and in the conventional fluoroscopy images in cases of minimally invasive percutaneous approach may be necessary.…”

Section: Effect Of Facet Degenerationmentioning

confidence: 99%

Maintenance of Integrity of Upper Facet Joints during Simulated Percutaneous Pedicle Screw Insertion Using 2D versus 3D Planning

Archavlis

Ringel

Kantelhardt

2019

J Neurol Surg A Cent Eur Neurosurg

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Background No studies have directly and quantitatively compared two-dimensional (2D) and three-dimensional (3D) planning as applied during conventional percutaneous or navigated percutaneous pedicle screw placement. Study Aims This lumbar pedicle-based stabilization simulation study aimed to investigate the risk of upper facet joint violation (FJV) during posterior percutaneous pedicle screw placement with conventional 2D planning of screw implantation (as a model for fluoroscopically guided screws) compared with 3D planning (as used with navigation techniques). Methods The placement of monosegmental lumbar pedicle screws using the data sets of 250 consecutive patients was simulated. Conventional surgery (using 2D fluoroscopic images anteroposterior and lateral view) was compared with screw placement using the 3D reconstruction of the planning mode of the same software. Results The 2D planning resulted in 140 upper FJVs (28% of cases), whereas 3D planning resulted in only 24 upper FJVs (4.8% of cases) (p < 0.05). Among those spinal segments with severe facet joint arthropathy, Pathria grades 3 and 4, FJV was significantly higher (p < 0.05) in the 2D-planned screws (64.7%) than in the 3D-planned screws (11.2%). A more lateral (mean distance: 3.5 mm) and inferior (mean distance: 2.5 mm) offset of the pedicle entry point and a larger medial angulation of the trajectory (mean angle: 9 degrees) were observed for the 3D-planned screws at all levels. Conclusion This study demonstrates that the use of 2D planning is associated with a higher risk of upper FJV than when a 3D imaging data set is used. Using a more lateral and inferior entry point for fluoroscopically guided pedicle screws could reduce the rate of FJV in percutaneous pedicle screw placement.

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“…Generally, the optimal entry point of pedicle screws is at the intersection of the pars interarticularis, the midpoint of the transverse process, and the inferior point of the superior articular facet (Koon, 2010;Oh, et al, 2013). Using US as a type of guidance would potentially provide a real-time imaging alternative for the identification of dorsal anatomic landmarks.…”

Section: Discussion and Future Workmentioning

confidence: 99%

Automatic Scan Plane Identification from 2D Ultrasound for Pedicle Screw Guidance

Qi¹,

Vora²,

Riera³

et al.

EPiC Series in Health Sciences

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In order to reduce the total amount of radiation exposure and provide real-time guidance ultrasound has been incorporated as a potential intra-operative imaging modality into various orthopedic procedures. However, high levels of noise, various imaging artifacts, and bone boundaries appearing several millimeters in thickness hinder the success of ultrasound as an alternative imaging modality in assisting orthopedic surgery procedures. Additional difficulties are also encountered during manual operation of the ultrasound transducer during image acquisition. In this work, we proposed a combination of novel scan plane identification method, based on convolutional neural networks, and bone surface localization method. The bone surface localization approach utilizes both local phase information, a combination of three different local image phase information and signal transmission map obtained from an L1 norm based contextual regularization method. The proposed network was utilized on two different US systems and to identify five different scan planes. Validation was performed on scans obtained from 16 volunteers. The correct scan plane identification rate of over 93% has been obtained. Validation against expert segmentation achieved a mean vertebra surface localization error of 0.42 mm.

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Technical Report of Free Hand Pedicle Screw Placement using the Entry Points with Junction of Proximal Edge of Transverse Process and Lamina in Lumbar Spine: Analysis of 2601 Consecutive Screws

Cited by 28 publications

References 34 publications

The three-dimensional printed template guided technique for S2AI screw placement and a comparison with freehand technique

The three-dimensional printed template guided technique for S2AI screw placement and a comparison with freehand technique

Maintenance of Integrity of Upper Facet Joints during Simulated Percutaneous Pedicle Screw Insertion Using 2D versus 3D Planning

Automatic Scan Plane Identification from 2D Ultrasound for Pedicle Screw Guidance

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