Standard open techniques for pedicle screws placement require extensive tissue dissection for optimal screw trajectory. Furthermore, they have been associated with extensive blood loss, long hospital stays and, consequently, significant costs. Objective: To describe a percutaneous pedicle screw fixation performed with a novel navigated “one-step” system, underlining the safety and effectiveness of such technique. Methods: During a 43-month period, 43 patients with 230 pedicle screws were evaluated. Percutaneous pedicle screw fixation was performed in the lumbosacral region in 5 patients (12%), lumbar region in 13 (30%), thoracolumbar region in 21 (49%) and thoracic region in 4 (9%). We have compared the accuracy rates of screw placement achieved with percutaneous pedicle screw fixation using fluoroscopy, and neuronavigated percutaneous pedicle screw fixation using an innovative “one-step” technique. Results: Statistical differences in screws placement accuracy between the group A and B were evaluated by Fisher exact test. The accuracy rate of pedicle screws placement in group with the intraoperative navigation system was higher than that of the group with fluoroscopy (P = 0.04). There was no hardware failure except 3 screws of Group A (1.3%) that pulled out few weeks after surgery, There were a total of 6 SAR (2.61%) and only 1 of them belonged to group B, without the need of revision surgery (0.61% out of the total neuronavigated stabilizations), while the other 5 represent 7.35% of the total screws placed with fluoroscopy. In our patient series the risk of mispositioning has been reduced by 14.95% with the use of the neuronavigation system, considering as malposition the set of IMP and SAR. Conclusions: Percutaneous pedicle screw fixation with neuronavigated “one-step” technique represents a safe and effective tool in minimally invasive spine surgery that deserves a further investigation and widespread diffusion

Umana, G.e., Scalia, G., Perrone, C., Garaci, F., Pagano, A., De Luna, A., et al. (2020). Safety and efficacy of navigated trocarless pedicle screw placement: technical note. INTERDISCIPLINARY NEUROSURGERY, 21 [10.1016/j.inat.2020.100771].

Safety and efficacy of navigated trocarless pedicle screw placement: technical note

Umana, Giuseppe Emmanuele;Garaci, Francesco
;
Lunardi, Pierpaolo
2020-01-01

Abstract

Standard open techniques for pedicle screws placement require extensive tissue dissection for optimal screw trajectory. Furthermore, they have been associated with extensive blood loss, long hospital stays and, consequently, significant costs. Objective: To describe a percutaneous pedicle screw fixation performed with a novel navigated “one-step” system, underlining the safety and effectiveness of such technique. Methods: During a 43-month period, 43 patients with 230 pedicle screws were evaluated. Percutaneous pedicle screw fixation was performed in the lumbosacral region in 5 patients (12%), lumbar region in 13 (30%), thoracolumbar region in 21 (49%) and thoracic region in 4 (9%). We have compared the accuracy rates of screw placement achieved with percutaneous pedicle screw fixation using fluoroscopy, and neuronavigated percutaneous pedicle screw fixation using an innovative “one-step” technique. Results: Statistical differences in screws placement accuracy between the group A and B were evaluated by Fisher exact test. The accuracy rate of pedicle screws placement in group with the intraoperative navigation system was higher than that of the group with fluoroscopy (P = 0.04). There was no hardware failure except 3 screws of Group A (1.3%) that pulled out few weeks after surgery, There were a total of 6 SAR (2.61%) and only 1 of them belonged to group B, without the need of revision surgery (0.61% out of the total neuronavigated stabilizations), while the other 5 represent 7.35% of the total screws placed with fluoroscopy. In our patient series the risk of mispositioning has been reduced by 14.95% with the use of the neuronavigation system, considering as malposition the set of IMP and SAR. Conclusions: Percutaneous pedicle screw fixation with neuronavigated “one-step” technique represents a safe and effective tool in minimally invasive spine surgery that deserves a further investigation and widespread diffusion
2020
Pubblicato
Rilevanza internazionale
Articolo
Comitato scientifico
Settore MED/27 - NEUROCHIRURGIA
English
Con Impact Factor ISI
Lumbar spine; Pedicle screws; Mispositioning; One-step
https://doi.org/10.1016/j.inat.2020.100771
Umana, G.e., Scalia, G., Perrone, C., Garaci, F., Pagano, A., De Luna, A., et al. (2020). Safety and efficacy of navigated trocarless pedicle screw placement: technical note. INTERDISCIPLINARY NEUROSURGERY, 21 [10.1016/j.inat.2020.100771].
Umana, Ge; Scalia, G; Perrone, C; Garaci, F; Pagano, A; De Luna, A; Cicero, S; Visocchi, M; Nicoletti, Gf; Germanò, A; Lunardi, P
Articolo su rivista
File in questo prodotto:
File Dimensione Formato  
Peduncolo 2020.pdf

accesso aperto

Descrizione: Articolo principale
Tipologia: Versione Editoriale (PDF)
Licenza: Copyright dell'editore
Dimensione 1.29 MB
Formato Adobe PDF
1.29 MB Adobe PDF Visualizza/Apri

I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.

Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/2108/248657
Citazioni
  • ???jsp.display-item.citation.pmc??? ND
  • Scopus 18
  • ???jsp.display-item.citation.isi??? 13
social impact