High Accuracy of Three-Dimensional Navigated Kirschner-Wire-Less Single-Step Pedicle Screw System (SSPSS) in Lumbar Fusions: Comparison of Intraoperatively Planned versus Final Screw Position
Abstract
:1. Introduction
2. Materials and Methods
2.1. Patient Information
2.2. Surgical Approach
- A skin incision is marked using navigation guidance.
- Navigation is manually verified using the Brainlab pointer to identify and palate a transverse process at a distance from the reference array.
- The navigated screw with the screw driver is calibrated.
- After inserting the screw, the screws are test stimulated with an extended electrode probe. A threshold of 8 mA is used to consider screw repositioning.
- A final intraoperative CT is completed with the navigation reference in place in case of further instrument adjustment or decompression.
- The patient’s wound is generously irrigated and washed after meticulous hemostasis is performed. Osteo-stimulative bone graft is packed under the rod. Local anesthesia is used to infiltrate the muscle and the wound is closed [6].
2.3. Analysis
3. Results
3.1. Patient and Surgery Characteristics
3.2. Screw Placement and Accuracy
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Characteristic | Frequency (n = 47) |
---|---|
Age (years) | 64.1 ± 13.3 |
Sex | |
Male | 24 (51.1%) |
Female | 23 (49.9%) |
BMI (kg/m2) | 27.6 ± 5.1 |
Fusion technique | |
ALIF | 2 (4.3%) |
PLIF | 2 (4.3%) |
TLIF | 38 (80.9%) |
XLIF | 5 (10.6%) |
Number of levels fused | |
1 | 38 (80.9%) |
2 | 7 (14.9%) |
3 | 2 (4.3%) |
Primary Diagnosis | |
Spinal stenosis | 16 (34) |
Lumbar radiculopathy | 11 (23.4) |
Spondylolisthesis | 9 (19.1) |
DDD | 6 (12.8) |
Others | 5 (10.6) |
Revision during follow-up | 2 (4.3%) |
Adjacent segment disease | 2 |
Blood Loss (n, %) | |
<50 mL | 13 (27.7) |
50–150 mL | 23 (48.9) |
>150 mL | 11 (23.4) |
Duration of surgery (minutes), median (IQR) | 182 (144–225) |
Length of hospital stay (hours), median (IQR) | 48 (24–108) |
Vertebral Body | Screw Position | Total | |
---|---|---|---|
Right | Left | ||
L1 | 1 | 1 | 2 |
L2 | 2 | 2 | 4 |
L3 | 10 | 10 | 20 |
L4 | 34 (2) * | 34 (4) * | 68 |
L5 | 42 | 42 (3) * | 84 |
S1 | 14 (1) * | 14 | 28 |
Total | 103 | 103 | 206 |
Inserted Screws | |||||
---|---|---|---|---|---|
Planned | A | B | C | Total | |
A | 195 | 8 | 1 | 204 | |
B | 1 | 1 | 0 | 2 | |
C | 0 | 0 | 0 | 0 | |
Total | 196 | 9 | 1 | 206 |
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Share and Cite
Bielecki, M.; Boadi, B.I.; Xie, Y.; Ikwuegbuenyi, C.A.; Farooq, M.; Berger, J.; Hernández-Hernández, A.; Hussain, I.; Härtl, R. High Accuracy of Three-Dimensional Navigated Kirschner-Wire-Less Single-Step Pedicle Screw System (SSPSS) in Lumbar Fusions: Comparison of Intraoperatively Planned versus Final Screw Position. Brain Sci. 2024, 14, 873. https://doi.org/10.3390/brainsci14090873
Bielecki M, Boadi BI, Xie Y, Ikwuegbuenyi CA, Farooq M, Berger J, Hernández-Hernández A, Hussain I, Härtl R. High Accuracy of Three-Dimensional Navigated Kirschner-Wire-Less Single-Step Pedicle Screw System (SSPSS) in Lumbar Fusions: Comparison of Intraoperatively Planned versus Final Screw Position. Brain Sciences. 2024; 14(9):873. https://doi.org/10.3390/brainsci14090873
Chicago/Turabian StyleBielecki, Mateusz, Blake I. Boadi, Yizhou Xie, Chibuikem A. Ikwuegbuenyi, Minaam Farooq, Jessica Berger, Alan Hernández-Hernández, Ibrahim Hussain, and Roger Härtl. 2024. "High Accuracy of Three-Dimensional Navigated Kirschner-Wire-Less Single-Step Pedicle Screw System (SSPSS) in Lumbar Fusions: Comparison of Intraoperatively Planned versus Final Screw Position" Brain Sciences 14, no. 9: 873. https://doi.org/10.3390/brainsci14090873