Time Demand and Radiation Dose in 3D-Fluoroscopy-based Navigation-assisted 3D-Fluoroscopy-controlled Pedicle Screw Instrumentations.

Abstract:

STUDY DESIGN:Prospective single-center cohort study to record additional time requirements and radiation dose in navigation-assisted O-arm-controlled pedicle screw (PS) instrumentations. OBJECTIVE:The aim of this study was to evaluate amount of extra-time and radiation dose for navigation-assisted PS instrumentations of the thoracolumbosacral spine using O-arm 3D-real-time-navigation (O3DN) compared to non-navigated spinal procedures (NNSPs) with a single C-arm and postoperative computed tomography (CT) scan for controlling PS positions. SUMMARY OF BACKGROUND DATA:3D-navigation is reported to enhance PS insertion accuracy. But time-consuming navigational steps and considerable additional radiation doses seem to limit this modern technique's attraction. A detailed analysis of additional time demand and extra-radiation dose in 3D-navigated spine surgery is not provided in literature, yet. METHODS:From February 2011 through July 2015, 306 consecutive posterior instrumentations were performed in vertebral levels T10-S1 using O3DN for PS insertion. The duration of procedure-specific navigational steps of the overall collective (I) and the last cohort of 50 consecutive O3DN-surgeries (II) was compared to the average duration of analogous surgical steps in 100 consecutive NNSP using a single C-arm. 3D-radiation dose (dose-length-product, DLP) of navigational and postinstrumentation O-arm scans in group I and II was compared to the average DLP of 100 diagnostic lumbar CT scans. RESULTS:The average presurgical time from patient positioning on the operating table to skin incision was 46.2 ± 10.1 minutes (O3DN, I) and 40.6 ± 9.8 minutes (O3DN, II) versus 30.6 ± 8.3 minutes (NNSP) (P < 0.001, each). Intraoperative interruptions for scanning and data processing took 3.0 ± 0.6 minutes. DLPs averaged 865.1 ± 360.8 mGycm (O3DN, I) and 562.1 ± 352.6 mGycm (O3DN, II) compared to 575.5 ± 316.5 mGycm in diagnostic lumbar CT scans (P < 0.001 (I), P ≈ 0.81 [II]). CONCLUSION:After procedural experience, navigated surgeries can be performed with an additional time demand of 13.0 minutes compared to NNSP, and with a total DLP below that of a diagnostic lumbar CT scan (P ≈ 0.81). LEVEL OF EVIDENCE:4.

journal_name

Spine (Phila Pa 1976)

journal_title

Spine

authors

Balling H

doi

10.1097/BRS.0000000000002422

subject

Has Abstract

pub_date

2018-05-01 00:00:00

pages

E512-E519

issue

9

eissn

0362-2436

issn

1528-1159

pii

00007632-201805010-00008

journal_volume

43

pub_type

杂志文章

相关文献

SPINE文献大全
  • Cervical Alignment Variations in Different Postures and Predictors of Normal Cervical Kyphosis: A New Understanding.

    abstract:STUDY DESIGN:Comparative study of prospectively collected radiographic data. OBJECTIVE:To predict physiological alignment of the cervical spine and study its morphology in different postures. SUMMARY OF BACKGROUND DATA:There is increasing evidence that normal cervical spinal alignment may vary from lordosis to neutra...

    journal_title:Spine

    pub_type: 杂志文章

    doi:10.1097/BRS.0000000000002160

    authors: Hey HWD,Lau ET,Wong GC,Tan KA,Liu GK,Wong HK

    更新日期:2017-11-01 00:00:00

  • An acute cervical epidural hematoma as a complication of dry needling.

    abstract:STUDY DESIGN:A retrospective case report. OBJECTIVE:The objective of this article is to report an unusual complication of dry needling. SUMMARY OF BACKGROUND DATA:Epidural hematomas after dry needling are quite unusual and only a few cases of epidural hematoma after acupuncture have been reported in the literature. W...

    journal_title:Spine

    pub_type: 杂志文章

    doi:10.1097/BRS.0b013e3181fc1e38

    authors: Lee JH,Lee H,Jo DJ

    更新日期:2011-06-01 00:00:00

  • The response of the nucleus pulposus of the lumbar intervertebral discs to functionally loaded positions.

    abstract:STUDY DESIGN:Asymptomatic volunteers underwent magnetic resonance imaging to investigate how different positions affect lumbar intervertebral discs. OBJECTIVE:To quantify sagittal migration of the lumbar nucleus pulposus in 6 functional positions. SUMMARY OF BACKGROUND DATA:Previous studies of the intervertebral disc...

    journal_title:Spine

    pub_type: 杂志文章

    doi:10.1097/BRS.0b013e318067dccb

    authors: Alexander LA,Hancock E,Agouris I,Smith FW,MacSween A

    更新日期:2007-06-15 00:00:00

  • Predictors of Vertebral Artery Injury in Isolated C2 Fractures Based on Fracture Morphology Using CT Angiography.

    abstract:STUDY DESIGN:Retrospective database analysis. OBJECTIVE:To determine C2 fracture patterns associated with vertebral artery injury (VAI) as assessed by computed tomography angiography. SUMMARY OF BACKGROUND DATA:The incidence of C2 fracture hospitalizations has increased significantly in the last decade. The vertebral...

    journal_title:Spine

    pub_type: 杂志文章

    doi:10.1097/BRS.0000000000000893

    authors: Durand D,Wu X,Kalra VB,Abbed KM,Malhotra A

    更新日期:2015-06-15 00:00:00

  • Trunk sway measures of postural stability during clinical balance tests in patients with chronic whiplash injury symptoms.

    abstract:STUDY DESIGN:Trunk sway occurring during clinical stance and gait tasks was compared between a group of subjects with a chronic whiplash injury, resulting from an automobile collision, and a normal collective. OBJECTIVES:To examine if population specific trunk sway patterns for stance and gait could be identified for ...

    journal_title:Spine

    pub_type: 临床试验,杂志文章

    doi:10.1097/01.BRS.0000083170.34304.A3

    authors: Sjöström H,Allum JH,Carpenter MG,Adkin AL,Honegger F,Ettlin T

    更新日期:2003-08-01 00:00:00

  • Electronic monitoring improves brace-wearing compliance in patients with adolescent idiopathic scoliosis: a randomized clinical trial.

    abstract:STUDY DESIGN:Randomized controlled trial. OBJECTIVE:To assess whether monitoring increases brace-wearing compliance in patients with adolescent idiopathic scoliosis (AIS). SUMMARY OF BACKGROUND DATA:Noncompliance is a barrier to brace treatment of AIS. Studies have demonstrated that monitoring improves medication com...

    journal_title:Spine

    pub_type: 杂志文章,随机对照试验

    doi:10.1097/BRS.0b013e31822f4306

    authors: Miller DJ,Franzone JM,Matsumoto H,Gomez JA,Avendaño J,Hyman JE,Roye DP Jr,Vitale MG

    更新日期:2012-04-20 00:00:00

  • Analysis of risk factors associated with fusion failure after anterior odontoid screw fixation.

    abstract:STUDY DESIGN:Retrospective study. OBJECTIVE:To evaluate the incidence of fusion failure after anterior screw fixation of type II and rostral shallow type III fractures and to identify related risk factors. SUMMARY OF BACKGROUND DATA:Although several studies have reported fusion rates after anterior odontoid screw fix...

    journal_title:Spine

    pub_type: 杂志文章

    doi:10.1097/BRS.0b013e31820e6418

    authors: Cho DC,Sung JK

    更新日期:2012-01-01 00:00:00

  • Saphenous nerve somatosensory evoked potentials: a novel technique to monitor the femoral nerve during transpsoas lumbar lateral interbody fusion.

    abstract:STUDY DESIGN:A retrospective analysis of a case series was performed. OBJECTIVE:To describe a novel technique to monitor femoral nerve function by analyzing the saphenous nerve somatosensory evoked potential (SSEP) during transpsoas surgical exposures of the lumbar spine. SUMMARY OF BACKGROUND DATA:During transpsoas ...

    journal_title:Spine

    pub_type: 杂志文章

    doi:10.1097/BRS.0000000000000357

    authors: Silverstein J,Mermelstein L,DeWal H,Basra S

    更新日期:2014-07-01 00:00:00

  • Ultrastructure of the human interspinous ligament and ligamentum flavum. A preliminary study.

    abstract::The ultrastructure of ligamenta flava (LF) and interspinous ligaments (ISL) obtained from four patients who underwent surgery for vertebral fracture (control group) and five patients operated for disc herniation was studied. The fine structure of LF was composed of elastic and elaunin fibers. Small diameter collagen f...

    journal_title:Spine

    pub_type: 杂志文章

    doi:10.1097/00007632-199004000-00002

    authors: Yahia LH,Garzon S,Strykowski H,Rivard CH

    更新日期:1990-04-01 00:00:00

  • The correlation of preoperative three-dimensional computed tomography reconstructions with operative findings in congenital scoliosis.

    abstract:STUDY DESIGN:A retrospective radiographic and chart review of patients who underwent computed tomography with three-dimensional reconstructions before single stage anterior and posterior hemivertebra excision. OBJECTIVE:To assess the efficacy of three-dimensional computed tomography reconstructions in accurately ident...

    journal_title:Spine

    pub_type: 杂志文章

    doi:10.1097/01.BRS.0000092382.80487.F0

    authors: Hedequist DJ,Emans JB

    更新日期:2003-11-15 00:00:00

  • The functional rating index: reliability and validity of the Persian language version in patients with neck pain.

    abstract:STUDY DESIGN:Psychometric testing of the Persian Functional Rating Index (PFRI). OBJECTIVE:To determine the reliability and validity of the PFRI in Persian-speaking subjects with neck pain (NP). SUMMARY OF BACKGROUND DATA:The Functional Rating Index is a self-report questionnaire that can be used for patients with ba...

    journal_title:Spine

    pub_type: 杂志文章

    doi:10.1097/BRS.0b013e31824b5bde

    authors: Ansari NN,Feise RJ,Naghdi S,Mohseni A,Rezazadeh M

    更新日期:2012-06-15 00:00:00

  • Congenital absence of lumbar facets as a cause of lower-back pain.

    abstract::Unilateral arch hypertrophy secondary to congenital absence of lumbar articular facets is a rare condition of still undetermined etiology. Most symptomatic cases had a history of mild trauma. Radiologic criteria using plain films and CAT scan are available to make the diagnosis of unilateral arch hypertrophy and the s...

    journal_title:Spine

    pub_type: 杂志文章

    doi:10.1097/00007632-198601000-00024

    authors: Segal D,Franchi AV

    更新日期:1986-01-01 00:00:00

  • Potential Selection Bias in Observational Studies Comparing Cervical Disc Arthroplasty to Anterior Cervical Discectomy and Fusion.

    abstract:STUDY DESIGN:Retrospective study using a national administrative database. OBJECTIVE:To define the cohort differences in patient characteristics between patients undergoing cervical disc arthroplasty (CDA) and anterior cervical discectomy and fusion (ACDF) in a large national sample, and to describe the impact of thos...

    journal_title:Spine

    pub_type: 杂志文章

    doi:10.1097/BRS.0000000000003427

    authors: Goz V,Martin BI,Donnally CJ 3rd,Brodke D,Spina N,Lawrence B,Spiker WR

    更新日期:2020-07-15 00:00:00

  • Natural history of progressive adult scoliosis.

    abstract:STUDY DESIGN:A retrospective analysis of the progression of adult scoliosis. OBJECTIVE:To establish an individual prognosis. SUMMARY OF BACKGROUND DATA:Most studies have investigated the adolescent scoliosis after skeletal maturity, but the results are discordant. METHODS:Two senior physicians measured all the radio...

    journal_title:Spine

    pub_type: 杂志文章

    doi:10.1097/01.brs.0000263328.89135.a6

    authors: Marty-Poumarat C,Scattin L,Marpeau M,Garreau de Loubresse C,Aegerter P

    更新日期:2007-05-15 00:00:00

  • Higher electrical stimulus intensities are required to activate chronically compressed nerve roots. Implications for intraoperative electromyographic pedicle screw testing.

    abstract:STUDY DESIGN:A comparison of the electrical thresholds required to evoke myogenic responses from direct stimulation of normal and chronically compressed nerve roots. OBJECTIVE:To determine whether intraoperative electromyographic testing to confirm the integrity of instrumented pedicles should be performed at higher s...

    journal_title:Spine

    pub_type: 杂志文章

    doi:10.1097/00007632-199801150-00014

    authors: Holland NR,Lukaczyk TA,Riley LH 3rd,Kostuik JP

    更新日期:1998-01-15 00:00:00

  • The predictive value of the fulcrum bending radiograph in spontaneous apical vertebral derotation in adolescent idiopathic scoliosis.

    abstract:STUDY DESIGN:A prospective cohort study of Cobb angles (CA) and apical vertebral rotations (AVR) in 25 patients who had adolescent idiopathic scoliosis. OBJECTIVE:To assess in vivo the concomitant vertebral derotation occurring with correction of scoliosis deformity as a result of coupling effect by using the fulcrum ...

    journal_title:Spine

    pub_type: 杂志文章

    doi:10.1097/BRS.0b013e31824f108f

    authors: Luk KD,Cheung WY,Wong Y,Cheung KM,Wong YW,Samartzis D

    更新日期:2012-07-01 00:00:00

  • Association Between Surgeon Experience and Complication Rates in Adult Scoliosis Surgery: A Review of 5117 Cases From the Scoliosis Research Society Database 2004-2007.

    abstract:STUDY DESIGN:Retrospective review of a multicenter database. OBJECTIVE:To evaluate whether surgeon experience is associated with complication rates in adult spinal deformity (ASD) surgery. SUMMARY OF BACKGROUND DATA:Multiple patient- and surgery-related factors have been shown to increase the risk of complications in...

    journal_title:Spine

    pub_type: 杂志文章

    doi:10.1097/BRS.0000000000000993

    authors: Skovrlj B,Cho SK,Caridi JM,Bridwell KH,Lenke LG,Kim YJ

    更新日期:2015-08-01 00:00:00

  • Craniocervical junction subarachnoid hemorrhage associated with atlanto-occipital dislocation.

    abstract:STUDY DESIGN:The sensitivity of plain radiographs for diagnosing traumatic atlanto-occipital dislocation and its association with craniocervical junction subarachnoid hemorrhage was examined in a retrospective review of seven patients. OBJECTIVE:The purpose of this study was to demonstrate the frequency of nondiagnost...

    journal_title:Spine

    pub_type: 杂志文章

    doi:10.1097/00007632-199608010-00009

    authors: Przybylski GJ,Clyde BL,Fitz CR

    更新日期:1996-08-01 00:00:00

  • Porosity and Thickness of the Vertebral Endplate Depend on Local Mechanical Loading.

    abstract:STUDY DESIGN:Mechanical and microcomputed tomography (micro-CT) study of cadaver spines. OBJECTIVE:To compare porosity and thickness of vertebral endplates with (1) compressive stresses measured in adjacent intervertebral discs and (2) grade of disc degeneration. SUMMARY OF BACKGROUND DATA:Endplate porosity is import...

    journal_title:Spine

    pub_type: 杂志文章

    doi:10.1097/BRS.0000000000000925

    authors: Zehra U,Robson-Brown K,Adams MA,Dolan P

    更新日期:2015-08-01 00:00:00

  • Preoperative MRI analysis of patients with idiopathic scoliosis: a prospective study.

    abstract:STUDY DESIGN:A prospective trial of preoperative MRI study in patients with "idiopathic" scoliosis. OBJECTIVES:To investigate the prevalence of neural axis malformations and the clinical relevance of MRI in the evaluation of patients with idiopathic scoliosis undergoing surgical intervention. SUMMARY OF BACKGROUND DA...

    journal_title:Spine

    pub_type: 杂志文章

    doi:10.1097/01.brs.0000149075.96242.0e

    authors: Inoue M,Minami S,Nakata Y,Otsuka Y,Takaso M,Kitahara H,Tokunaga M,Isobe K,Moriya H

    更新日期:2005-01-01 00:00:00

  • Bilateral symptomatic synovial cysts of the lumbar spine caused by calcium pyrophosphate deposition disease: a case report.

    abstract:STUDY DESIGN:A case of bilateral symptomatic facet joint synovial cysts arising in association with calcium pyrophosphate deposition disease is reported. OBJECTIVE:To present a previously unreported cause for symptomatic synovial cysts of the lumbar spine. SUMMARY OF BACKGROUND DATA:Synovial cysts of the facet joints...

    journal_title:Spine

    pub_type: 杂志文章

    doi:10.1097/00007632-200210010-00024

    authors: Gadgil AA,Eisenstein SM,Darby A,Cassar Pullicino V

    更新日期:2002-10-01 00:00:00

  • Functional morphology of the thoracolumbar transversospinal muscles.

    abstract::STUDY DESIGN. A qualitative and semiquantitative study of the morphology of the human thoracolumbar transversospinal (TSP) muscles. OBJECTIVE. To further define the functional morphology of the thoracolumbar TSP muscles. SUMMARY OF BACKGROUND DATA. The TSP muscle group plays an important role in vertebral function but...

    journal_title:Spine

    pub_type: 杂志文章

    doi:10.1097/BRS.0b013e3181f79629

    authors: Cornwall J,Stringer MD,Duxson M

    更新日期:2011-07-15 00:00:00

  • The value of somatosensory- and motor-evoked potentials in predicting and monitoring the effect of therapy in spondylotic cervical myelopathy. Prospective randomized study.

    abstract:STUDY DESIGN:A 2-year follow-up prospective randomized electrophysiologic and clinical study of patients with spondylotic cervical myelopathy. OBJECTIVE:To assess the value of somatosensory- and motor-evoked potentials in the evaluation and prediction of the effect of therapy. SUMMARY OF BACKGROUND DATA:Previous stud...

    journal_title:Spine

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1097/00007632-199908010-00014

    authors: Bednarík J,Kadanka Z,Vohánka S,Stejskal L,Vlach O,Schröder R

    更新日期:1999-08-01 00:00:00

  • The use of mathematical models for studies of scoliosis biomechanics.

    abstract::The use of mathematical and other types of models for the study of the biomechanics of scoliosis is reviewed in this article. The article is based on a talk presented at the 1987 Meeting of the Scoliosis Research Society. ...

    journal_title:Spine

    pub_type: 杂志文章

    doi:10.1097/00007632-199110000-00014

    authors: Schultz AB

    更新日期:1991-10-01 00:00:00

  • Mechanical stability of thoracolumbar pedicle screw fixation. The effect of crosslinks.

    abstract:STUDY DESIGN:Pedicle screw fixation for unstable thoracolumbar spine injuries is relatively new. The effect of one or two crosslinks on rotational and lateral bending stiffness was studied. OBJECTIVE:To determine the rotational and bending stiffness values of thoracolumbar fractures fixed by the AO's internal fixation...

    journal_title:Spine

    pub_type: 杂志文章

    doi:10.1097/00007632-199707150-00007

    authors: Lynn G,Mukherjee DP,Kruse RN,Sadasivan KK,Albright JA

    更新日期:1997-07-15 00:00:00

  • Temporary external transpedicular fixation of the lumbosacral spine: a prospective, longitudinal study in 330 patients.

    abstract:STUDY DESIGN:In this study, 330 patients with incapacitating low back pain underwent temporary external transpedicular fixation (TETF) of the lumbosacral spine in a prospective trial. OBJECTIVE:To evaluate TETF as a test for selecting suitable candidates for segmental spinal fusion. SUMMARY OF BACKGROUND DATA:Few stu...

    journal_title:Spine

    pub_type: 临床试验,杂志文章

    doi:10.1097/01.brs.0000190868.57106.4d

    authors: Elmans L,Willems PC,Anderson PG,van Limbeek J,de Kleuver M,van der Schaaf D

    更新日期:2005-12-15 00:00:00

  • Effect of intensive training on the isokinetic strength and structure of lumbar muscles in patients with chronic low back pain.

    abstract:STUDY DESIGN:This study investigated the effects of the intensive physical rehabilitation program on the trunk and knee extensor muscles in patients with chronic low back pain. At baseline and after 3 months, strength was measured and muscle biopsies were taken. OBJECTIVES:To evaluate the effects of strength exercises...

    journal_title:Spine

    pub_type: 杂志文章

    doi:10.1097/00007632-199502000-00014

    authors: Rissanen A,Kalimo H,Alaranta H

    更新日期:1995-02-01 00:00:00

  • Biomechanical comparisons of spinal fracture models and the stabilizing effects of posterior instrumentations.

    abstract::In this study, the authors evaluated the stiffness of motion segments in intact spines in two spine fracture models, and with each of five implant systems used for posterior fixation of thoracolumbar spine fractures. The devices represented a cross-section of types, including those employing sublaminar wires with and ...

    journal_title:Spine

    pub_type: 杂志文章

    doi:10.1097/00007632-198805000-00003

    authors: Ferguson RL,Tencer AF,Woodard P,Allen BL Jr

    更新日期:1988-05-01 00:00:00

  • Cement augmentation in a thoracolumbar fracture model: reduction and stability after balloon kyphoplasty versus vertebral body stenting.

    abstract:STUDY DESIGN:In vitro biomechanical investigation. OBJECTIVE:To assess differences in kyphosis after balloon kyphoplasty (BKP) or vertebral body stenting (VBS). SUMMARY OF BACKGROUND DATA:Cement augmentation techniques allow early mobilization in patients with osteoporotic thoracolumbar fractures. Biomechanically, th...

    journal_title:Spine

    pub_type: 杂志文章

    doi:10.1097/BRS.0000000000000470

    authors: Disch AC,Schmoelz W

    更新日期:2014-09-01 00:00:00

  • Evaluation of the thoracolumbar injury classification system in thoracic and lumbar spinal trauma.

    abstract:STUDY DESIGN:Retrospective study. OBJECTIVE:Evaluate the relationship among the neurologic status, the Thoracolumbar Injury Classification System (TLICS) score, and the Magerl/AO classification system. SUMMARY OF THE BACKGROUND DATA:A wide range of classification schemes for thoracic and lumbar spine trauma have been...

    journal_title:Spine

    pub_type: 杂志文章,多中心研究

    doi:10.1097/BRS.0b013e3181c95047

    authors: Joaquim AF,Fernandes YB,Cavalcante RA,Fragoso RM,Honorato DC,Patel AA

    更新日期:2011-01-01 00:00:00