Publications by authors named "J K Gierse"

Cervical pedicle screws (CPS) provide biomechanically superior fixation compared to other techniques but are technically more demanding. Navigated CPS placement has been increasingly reported as a safe and accurate technique, yet there are few studies comparing different combinations of imaging and navigation systems under comparable conditions. With this study, we aimed to compare different imaging and navigation systems for CPS placement in terms of accuracy, screw placement time and applied radiation dose.

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Purpose: Intraoperative cone-beam CT imaging enables 3D validation of implant positioning and fracture reduction for orthopedic and trauma surgeries. However, the emergence of metal artifacts, especially in the vicinity of metallic objects, severely degrades the clinical value of the imaging modality. In previous works, metal artifact avoidance (MAA) methods have been shown to reduce metal artifacts by adapting the scanning trajectory.

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Background Context: Studies have shown biomechanical superiority of cervical pedicle screw placement over other techniques. However, accurate placement is challenging due to the inherent risk of neurovascular complications. Navigation technology based on intraoperative 3D imaging allows highly accurate screw placement, yet studies specifically investigating screw placement in patients with traumatic atlantoaxial injuries are scarce.

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Article Synopsis
  • Fractures of the thoracolumbar junction are common and often need surgical intervention, with this study focusing on comparing the accuracy of screw placement using 3D-navigation versus traditional fluoroscopy methods.
  • The study involved 25 patients each for both techniques, assessing screw accuracy through postoperative CT scans and other factors like surgery time and radiation exposure.
  • Results showed that while 3D-navigation achieved slightly higher screw placement accuracy (92.66% vs. 88.08%), there were no significant differences in surgery time, radiation exposure, or complications, indicating that 3D-navigation enhances accuracy without extending fluoroscopy time.
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Background: Intraoperative 3D imaging using cone-beam CT (CBCT) provides improved assessment of implant position and reduction in spine surgery, is used for navigated surgical techniques, and therefore leads to improved quality of care. However, in some cases the image quality is not sufficient to correctly assess pedicle screw position and reduction, especially due to metal artifacts. The aim of this study was to investigate whether changing the acquisition trajectory of the CBCT in relation to the pedicle screw position during dorsal instrumentation of the spine can reduce metal artifacts and consequently improve image quality as well as clinical assessability on the artificial bone model.

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