Comparison of accuracy of conventional and navigation pedicle screws in spine surgery
Journal Title: International Journal of Orthopaedics Sciences - Year 2017, Vol 3, Issue 3
Abstract
Introduction: Use of pedicle screw (PS) systems for spinal stabilization has become increasingly common in spine surgery. The technique and principle for pedicle screw instrumentation as well as anatomical landmarks of screw placement, however are common to all systems. The purpose of this study is to compare accuracy of pedicle screw placement with conventional and navigation techniques. Aim: To compare the accuracy of pedicle screw positioning between conventional and a new navigation system for the spine. Materials and Methods: It was a retrospective study in which 40 patients were randomly selected during the period between Jun-2014 to Jun-2016, operated for posterior fixation either through conventional and navigational spine surgery. Two independent observers analysed digital axial CT slices of all instrumented pedicles, with individual and consensus interpretation for each screw. A simple grading system (LAINE’s grading) was devised for evaluation of screw position. Results and Discussion: Overall accuracy of navigation technique is 95.89% (140/146) with 6 PS breach with laine’s grade 1 error all occurs in thoracic level, doesn’t results into any type of complications in manner of neurologic deficit or CSF leakage or dural tear etc. Overall accuracy of conventional PS placement is 89.84% (113/128) with 4 PS having grade 2 error and 11 PS having grade 3 error mainly occurs in thoracic level but none causes complication in any form i.e.; neurologic deficit, CSF leak, revision surgery etc. Conclusion: From our study, despite of high cost, preoperative registration and matching, more steep learning curve, needful of technician throught surgery, navigation surgery is better option in thoracic PS placement and spinal deformities due to complex morphology and anatomy of thoracic pedicles with rib cage obscuring fluoroscopic visualization making conventional surgery difficult with high rate of pedicle breach.
Authors and Affiliations
Dr. Prakash Vishnoi, Dr. Vishvas Modi
Keywords
Related Articles
- EP ID EP500425
- DOI 10.22271/ortho.2017.v3.i3l.127
- Views 95
- Downloads 0
Clinical profile of patients with fracture of Clavicle
It is estimated that one in every twenty fractures is a clavicle fracture. In fact 44% of all shoulder girdle fractures are clavicle fractures. The importance of proximity to vital structures in the neck and thorax neces...
To evaluate the role of high resolution ultrasonography in diagnosis of knee osteoarthritis
Introduction: Osteoarthritis (OA) is a progressive and disabling joint disease. It is one of the most frequently occurring health problems for middle-aged and older people. [1, 2] OA can occur in every synovial joint, bu...
Occurrence of fracture neck femur in the elderly Indian population
Background: The incidence of femoral neck fractures, one of the most common traumatic injuries in the elderly increases continuously due to the ageing of population on the planet and urbanization. Aims and Objective of t...
To compare the effect of different time ratio of heat and cold in contrast bath on clinical improvement in plantar fascitis
Background: Contrast bath is commonly used therapy in plantar fascitis. However there is no standard regimen followed as to the order and time ratio of hot and cold fomentation. This study was conducted to establish a st...
A prospective randomized pilot study of steroid modulation of cytokine (Interleukin 6) release in unilateral total knee replacement surgeries
Several studies evaluating the patients undergoing joint replacement have found elevation in the levels of cytokine interleukin-6(IL-6). High level of IL-6 after the major surgeries have been linked to postoperative feve...