One-step Minimally Invasive Pedicle Screw Instrumentation Utilizing O-Arm and Stealth Navigation.
Clin Backbone Surg. 2018 Jan 31;:
Authors: Kleck CJ, Johnson C, Akiyama M, Burger EL, Cain CJ, Patel VV
STUDY DESIGN: Description of a navigated, single-step, minimally invasive approach for the position of pedicle screws.
OBJECTIVE: To explain a brand new approach for minimally invasive placement of pedicle screws within the lumbar backbone utilizing O-arm and StealthStation navigation together.
SUMMARY OF BACKGROUND DATA: Minimally invasive surgical methods are described within the literature as secure and efficient strategies for pedicle screw instrumentation. These methods improve radiation publicity and immediate a number of instrument passes by way of the pedicle.
MATERIALS AND METHODS: In complete, 35 grownup sufferers (187 screws) underwent lumbar surgical procedure with pedicle screw placement utilizing the 1- (eight sufferers/48 screws) or 2-step (27 sufferers/139 screws) approach. Issues related to instrumentation have been famous. Pedicle screw place was evaluated.
RESULTS: Of 187 screws positioned, 181 (96.eight%) have been discovered to be absolutely contained throughout the pedicle (grade 1) and four (2.1%) had a breach of <2?mm. Within the 1-step approach, no screws have been malpositioned. One screw at S1 with insufficient fixation was changed with a screw 1?mm bigger in diameter. Within the 2-step approach, 2 screws (1.06% total) have been revised on account of inferior breach of the pedicle. No neurological sequelae have been famous. Additionally, 1 screw was deemed too lengthy at S1 and was changed with a shorter screw. Not one of the revised pedicle screws precipitated neuromonitoring adjustments and the breaches have been discovered intraoperatively on 3D imaging.
CONCLUSIONS: Utilizing O-arm and StealthStation navigation with minimally invasive surgical expertise for placement of posterior spinal instrumentation is secure, efficient, and limits radiation publicity.
PMID: 29389770 [PubMed – as supplied by publisher]