Abstract:
STUDY DESIGN:Description of a navigated, single-step, minimally invasive technique for the placement of pedicle screws. OBJECTIVE:To describe a new technique for minimally invasive placement of pedicle screws in the lumbar spine using O-arm and StealthStation navigation in combination. SUMMARY OF BACKGROUND DATA:Minimally invasive surgical techniques are described in the literature as safe and effective methods for pedicle screw instrumentation. These techniques increase radiation exposure and prompt multiple instrument passes through the pedicle. MATERIALS AND METHODS:In total, 35 adult patients (187 screws) underwent lumbar surgery with pedicle screw placement using the 1- (8 patients/48 screws) or 2-step (27 patients/139 screws) technique. Complications associated with instrumentation were noted. Pedicle screw position was evaluated. RESULTS:Of 187 screws placed, 181 (96.8%) were found to be fully contained within the pedicle (grade 1) and 4 (2.1%) had a breach of <2 mm. In the 1-step technique, no screws were malpositioned. One screw at S1 with inadequate fixation was replaced with a screw 1 mm larger in diameter. In the 2-step technique, 2 screws (1.06% overall) were revised due to inferior breach of the pedicle. No neurological sequelae were noted. Also, 1 screw was deemed too long at S1 and was replaced with a shorter screw. None of the revised pedicle screws caused neuromonitoring changes and the breaches were found intraoperatively on 3D imaging. CONCLUSIONS:Using O-arm and StealthStation navigation with minimally invasive surgical technology for placement of posterior spinal instrumentation is safe, effective, and limits radiation exposure.
journal_name
Clin Spine Surgjournal_title
Clinical spine surgeryauthors
Kleck CJ,Johnson C,Akiyama M,Burger EL,Cain CJ,Patel VVdoi
10.1097/BSD.0000000000000616subject
Has Abstractpub_date
2018-06-01 00:00:00pages
197-202issue
5eissn
2380-0186issn
2380-0194journal_volume
31pub_type
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