Objective: This study sought to 1) describe the use K-wireless pedicle screw insertion among adults (age ≥18 years) undergoing a minimally invasive fusion and 2) perform a systematic review (SR) of all studies that describe a navigated, K-wireless technique with 3-dimensional fluoroscopy.
Methods: Patients undergoing a minimally invasive fusion requiring pedicle screw fixation for any indication were prospectively enrolled in the observational component of this study. An assessment of pedicle breach was performed independently and in duplicate based on a modification of the Belmont grading scale. Articles for the SR were identified from a structured search of Medline from inception to May 8, 2019, without restriction of language.
Results: A total of 82 pedicle screws were placed in 20 patients who underwent surgery between January and June 2014. There was no significant difference in mean operative time between the cases included in this study and a matched cohort of 20 patients undergoing surgery with 2-dimensional fluoroscopy and K-wire-assisted pedicle screw placement (95 ± 13 vs. 87 ± 20 minutes, respectively; P > 0.05). There were 2 major pedicle breaches (Belmont grade 3) in a single patient, yielding a major breach rate of 2.44%. A total of 6 papers that described the placement of 700 pedicle screws in 160 patients between May 2011 and March 2017 were included in the SR. The overall breach rate was 7.00% (n = 37).
Conclusions: Percutaneous pedicle screws can be placed accurately and safely using 3-dimensional navigation without the use of K-wires and may confer benefits to patients and clinicians by reducing K-wire-associated complications and radiation exposure.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1016/j.wneu.2020.02.079 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Impact of pedicle screw accuracy on clinical outcomes after 1- or 2-level minimally invasive transforaminal lumbar interbody fusion.
J Neurosurg Spine
January 2025
1Department of Spine Surgery, Hospital for Special Surgery, New York.
Objective: When creating minimally invasive spine fusion constructs, accurate pedicle screw fixation is essential for biomechanical strength and avoiding complications arising from delicate surrounding structures. As research continues to analyze how to improve accuracy, long-term patient outcomes based on screw accuracy remain understudied. The objective of this study was to analyze long-term patient outcomes based on screw accuracy.
View Article and Find Full Text PDFC2 anatomical pedicle screw for C2 fixation under the concept of atlantoaxial joint distraction and fusion with intra-articular cages: technical note.
Eur Spine J
January 2025
Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, 45 Changchun Street, Xicheng District, Beijing, China.
Purpose: To describe a novel alternative technique for C2 fixation under the concept of atlantoaxial joint distraction and fusion with intra-articular Cages, and to report its preliminary clinical outcomes.
Methods: Eighteen patients with basilar invagination and atlantoaxial dislocation underwent atlantoaxial joint distraction and fusion with intra-articular Cages. All patients had hypoplasia of the C2 isthmus prohibiting insertion of the pedicle screw.
Retrospective comparison of cortical bone trajectory and pedicle screw in lumbar fusion for patients over 80, including sagittal balance: a single-center study.
BMC Geriatr
January 2025
Department of Neurosurgery, Yonsei University College of Medicine, 50, Yonsei-Ro, Seodaemun-Gu, Seoul, 03722, Republic of Korea.
Background: Comparative studies of posterior lumbar interbody fusion with cortical bone trajectory and pedicle screw in older patients, particularly in those aged ≥ 80 years, are rare. This study aimed to retrospectively analyze the clinical and surgical outcomes following posterior lumbar interbody fusion with pedicle screw fixation compared to cortical bone trajectory in patients aged ≥ 80 years with degenerative lumbar spine disease.
Methods: We included 68 patients aged ≥ 80 years who underwent degenerative lumbar spinal surgery at our spine center between January 2011 and December 2020.
Is intraoperative neuromonitoring the standard of care for pedicle screw placement surgery? A survey of neurosurgeons' practices.
Med Leg J
January 2025
Department of Neurosurgery, Tufts Medical Center, Tufts University School of Medicine, Boston, USA.
Spine surgery is highly litigious; misplaced screws and intraoperative neuromonitoring frequently feature in lawsuits. Intraoperative neuromonitoring aims to prevent injury but its standards are debated, and literature suggests its benefits are mixed. We surveyed its use among neurosurgeons from the Congress of Neurological Surgeons with Pearson's chi-square test applied to analyse data within R.
View Article and Find Full Text PDFAssociation between final local kyphosis angle and residual back pain in traumatic vertebral fractures at the thoracolumbar junction with posterior stabilization using percutaneous pedicle screws.
J Spine Surg
December 2024
Department of Orthopedic Surgery, Toyama Prefectural Central Hospital, Toyama City, Japan.
Background: There is no consensus on the association between final local kyphosis and residual back pain (RBP) after traumatic vertebral fracture. The aim of this study was to investigate whether there is an association between the final local kyphosis angle and RBP in patients with traumatic vertebral fractures at the thoracolumbar junction who underwent single posterior surgery with percutaneous pedicle screws and implant removal after fracture healing. A second goal was to determine the optimal cut-off value for the final local kyphosis angle with and without RBP.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!