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Accuracy and Safety of Pedicle Screw Placement for Treating Adolescent Idiopathic Scoliosis: A Narrative Review Comparing Available Techniques
Posterior spinal fusion and segmental spinal instrumentation using pedicle screws (PS) is the most used procedure to correct adolescent idiopathic scoliosis. Computed navigation, robotic navigation, and patient-specific drill templates are available, besides the first described free-hand technique....
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10378125/ https://www.ncbi.nlm.nih.gov/pubmed/37510146 http://dx.doi.org/10.3390/diagnostics13142402 |
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author | Ansorge, Alexandre Sarwahi, Vishal Bazin, Ludmilla Vazquez, Oscar De Marco, Giacomo Dayer, Romain |
author_facet | Ansorge, Alexandre Sarwahi, Vishal Bazin, Ludmilla Vazquez, Oscar De Marco, Giacomo Dayer, Romain |
author_sort | Ansorge, Alexandre |
collection | PubMed |
description | Posterior spinal fusion and segmental spinal instrumentation using pedicle screws (PS) is the most used procedure to correct adolescent idiopathic scoliosis. Computed navigation, robotic navigation, and patient-specific drill templates are available, besides the first described free-hand technique. None of these techniques are recognized as the gold standard. This review compares the PS placement accuracy and misplacement-related complication rates achieved with the techniques mentioned above. It further reports PS accuracy classifications and anatomic PS misplacement risk factors. The literature suggests a higher PS placement accuracy for robotic relative to computed navigation and for the latter relative to the free-hand technique (misplacement rates: 0.4–7.2% versus 1.9–11% versus 1.5–50.7%) using variable accuracy classifications. The reported PS-misplacement-related complication rates are, however, uniformly low (0–1.4%) for every technique, while robotic and computed navigation induce a roughly fourfold increase in the patient’s intraoperative radiation exposure relative to the free-hand technique with fluoroscopic implant positioning control. The authors, therefore, recommend dedicating robotic and computed navigation for complex deformities or revisions with altered landmarks, underline the need for a generally accepted PS accuracy classification, and advise against PS placement in grade 4 pedicles yielding higher misplacement rates (22.2–31.5%). |
format | Online Article Text |
id | pubmed-10378125 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-103781252023-07-29 Accuracy and Safety of Pedicle Screw Placement for Treating Adolescent Idiopathic Scoliosis: A Narrative Review Comparing Available Techniques Ansorge, Alexandre Sarwahi, Vishal Bazin, Ludmilla Vazquez, Oscar De Marco, Giacomo Dayer, Romain Diagnostics (Basel) Review Posterior spinal fusion and segmental spinal instrumentation using pedicle screws (PS) is the most used procedure to correct adolescent idiopathic scoliosis. Computed navigation, robotic navigation, and patient-specific drill templates are available, besides the first described free-hand technique. None of these techniques are recognized as the gold standard. This review compares the PS placement accuracy and misplacement-related complication rates achieved with the techniques mentioned above. It further reports PS accuracy classifications and anatomic PS misplacement risk factors. The literature suggests a higher PS placement accuracy for robotic relative to computed navigation and for the latter relative to the free-hand technique (misplacement rates: 0.4–7.2% versus 1.9–11% versus 1.5–50.7%) using variable accuracy classifications. The reported PS-misplacement-related complication rates are, however, uniformly low (0–1.4%) for every technique, while robotic and computed navigation induce a roughly fourfold increase in the patient’s intraoperative radiation exposure relative to the free-hand technique with fluoroscopic implant positioning control. The authors, therefore, recommend dedicating robotic and computed navigation for complex deformities or revisions with altered landmarks, underline the need for a generally accepted PS accuracy classification, and advise against PS placement in grade 4 pedicles yielding higher misplacement rates (22.2–31.5%). MDPI 2023-07-18 /pmc/articles/PMC10378125/ /pubmed/37510146 http://dx.doi.org/10.3390/diagnostics13142402 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Review Ansorge, Alexandre Sarwahi, Vishal Bazin, Ludmilla Vazquez, Oscar De Marco, Giacomo Dayer, Romain Accuracy and Safety of Pedicle Screw Placement for Treating Adolescent Idiopathic Scoliosis: A Narrative Review Comparing Available Techniques |
title | Accuracy and Safety of Pedicle Screw Placement for Treating Adolescent Idiopathic Scoliosis: A Narrative Review Comparing Available Techniques |
title_full | Accuracy and Safety of Pedicle Screw Placement for Treating Adolescent Idiopathic Scoliosis: A Narrative Review Comparing Available Techniques |
title_fullStr | Accuracy and Safety of Pedicle Screw Placement for Treating Adolescent Idiopathic Scoliosis: A Narrative Review Comparing Available Techniques |
title_full_unstemmed | Accuracy and Safety of Pedicle Screw Placement for Treating Adolescent Idiopathic Scoliosis: A Narrative Review Comparing Available Techniques |
title_short | Accuracy and Safety of Pedicle Screw Placement for Treating Adolescent Idiopathic Scoliosis: A Narrative Review Comparing Available Techniques |
title_sort | accuracy and safety of pedicle screw placement for treating adolescent idiopathic scoliosis: a narrative review comparing available techniques |
topic | Review |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10378125/ https://www.ncbi.nlm.nih.gov/pubmed/37510146 http://dx.doi.org/10.3390/diagnostics13142402 |
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