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Accuracy of Percutaneous Pedicle Screw Insertion Technique with Conventional Dual Fluoroscopy Units and a Retrospective Comparative Study Based on Surgeon Experience

Study Design Retrospective comparative study. Objective To evaluate the accuracy of percutaneous pedicle screw (PPS) placement and intraoperative imaging time using dual fluoroscopy units and their differences between surgeons with more versus less experience. Methods One hundred sixty-one patients...

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Autores principales: Nakahara, Masayuki, Yasuhara, Takao, Inoue, Takafumi, Takahashi, Yuichi, Kumamoto, Shinji, Hijikata, Yasukazu, Kusumegi, Akira, Sakamoto, Yushi, Ogawa, Koichi, Nishida, Kenki
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Georg Thieme Verlag KG 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4868583/
https://www.ncbi.nlm.nih.gov/pubmed/27190733
http://dx.doi.org/10.1055/s-0035-1563405
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author Nakahara, Masayuki
Yasuhara, Takao
Inoue, Takafumi
Takahashi, Yuichi
Kumamoto, Shinji
Hijikata, Yasukazu
Kusumegi, Akira
Sakamoto, Yushi
Ogawa, Koichi
Nishida, Kenki
author_facet Nakahara, Masayuki
Yasuhara, Takao
Inoue, Takafumi
Takahashi, Yuichi
Kumamoto, Shinji
Hijikata, Yasukazu
Kusumegi, Akira
Sakamoto, Yushi
Ogawa, Koichi
Nishida, Kenki
author_sort Nakahara, Masayuki
collection PubMed
description Study Design Retrospective comparative study. Objective To evaluate the accuracy of percutaneous pedicle screw (PPS) placement and intraoperative imaging time using dual fluoroscopy units and their differences between surgeons with more versus less experience. Methods One hundred sixty-one patients who underwent lumbar fusion surgery were divided into two groups, A (n = 74) and B (n = 87), based on the performing surgeon's experience. The accuracy of PPS placement and radiation time for PPS insertion were compared. PPSs were inserted with classic technique under the assistance of dual fluoroscopy units placed in two planes. The breach definition of PPS misplacement was based on postoperative computed tomography (grade I: no breach; grade II: <2 mm; grade III: ≤2 to <4 mm). Results Of 658 PPSs, only 21 screws were misplaced. The breach rates of groups A and B were 3.3% (grade II: 3.4%, grade III: 0%) and 3.1% (grade II: 2.6%, grade III: 0.6%; p = 0.91). One patient in grade III misplacement had a transient symptom of leg numbness. Median radiation exposure time during PPS insertion was 25 seconds and 51 seconds, respectively (p < 0.01). Conclusions Without using an expensive imaging support system, the classic technique of PPS insertion using dual fluoroscopy units in the lumbar and sacral spine is fairly accurate and provides good clinical outcomes, even among surgeons lacking experience.
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spelling pubmed-48685832016-06-01 Accuracy of Percutaneous Pedicle Screw Insertion Technique with Conventional Dual Fluoroscopy Units and a Retrospective Comparative Study Based on Surgeon Experience Nakahara, Masayuki Yasuhara, Takao Inoue, Takafumi Takahashi, Yuichi Kumamoto, Shinji Hijikata, Yasukazu Kusumegi, Akira Sakamoto, Yushi Ogawa, Koichi Nishida, Kenki Global Spine J Article Study Design Retrospective comparative study. Objective To evaluate the accuracy of percutaneous pedicle screw (PPS) placement and intraoperative imaging time using dual fluoroscopy units and their differences between surgeons with more versus less experience. Methods One hundred sixty-one patients who underwent lumbar fusion surgery were divided into two groups, A (n = 74) and B (n = 87), based on the performing surgeon's experience. The accuracy of PPS placement and radiation time for PPS insertion were compared. PPSs were inserted with classic technique under the assistance of dual fluoroscopy units placed in two planes. The breach definition of PPS misplacement was based on postoperative computed tomography (grade I: no breach; grade II: <2 mm; grade III: ≤2 to <4 mm). Results Of 658 PPSs, only 21 screws were misplaced. The breach rates of groups A and B were 3.3% (grade II: 3.4%, grade III: 0%) and 3.1% (grade II: 2.6%, grade III: 0.6%; p = 0.91). One patient in grade III misplacement had a transient symptom of leg numbness. Median radiation exposure time during PPS insertion was 25 seconds and 51 seconds, respectively (p < 0.01). Conclusions Without using an expensive imaging support system, the classic technique of PPS insertion using dual fluoroscopy units in the lumbar and sacral spine is fairly accurate and provides good clinical outcomes, even among surgeons lacking experience. Georg Thieme Verlag KG 2015-09-22 2016-06 /pmc/articles/PMC4868583/ /pubmed/27190733 http://dx.doi.org/10.1055/s-0035-1563405 Text en © Thieme Medical Publishers
spellingShingle Article
Nakahara, Masayuki
Yasuhara, Takao
Inoue, Takafumi
Takahashi, Yuichi
Kumamoto, Shinji
Hijikata, Yasukazu
Kusumegi, Akira
Sakamoto, Yushi
Ogawa, Koichi
Nishida, Kenki
Accuracy of Percutaneous Pedicle Screw Insertion Technique with Conventional Dual Fluoroscopy Units and a Retrospective Comparative Study Based on Surgeon Experience
title Accuracy of Percutaneous Pedicle Screw Insertion Technique with Conventional Dual Fluoroscopy Units and a Retrospective Comparative Study Based on Surgeon Experience
title_full Accuracy of Percutaneous Pedicle Screw Insertion Technique with Conventional Dual Fluoroscopy Units and a Retrospective Comparative Study Based on Surgeon Experience
title_fullStr Accuracy of Percutaneous Pedicle Screw Insertion Technique with Conventional Dual Fluoroscopy Units and a Retrospective Comparative Study Based on Surgeon Experience
title_full_unstemmed Accuracy of Percutaneous Pedicle Screw Insertion Technique with Conventional Dual Fluoroscopy Units and a Retrospective Comparative Study Based on Surgeon Experience
title_short Accuracy of Percutaneous Pedicle Screw Insertion Technique with Conventional Dual Fluoroscopy Units and a Retrospective Comparative Study Based on Surgeon Experience
title_sort accuracy of percutaneous pedicle screw insertion technique with conventional dual fluoroscopy units and a retrospective comparative study based on surgeon experience
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4868583/
https://www.ncbi.nlm.nih.gov/pubmed/27190733
http://dx.doi.org/10.1055/s-0035-1563405
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