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Posterior endpoint determination of the lumbar pedicle central axis on the anterior-posterior fluoroscopic image for pedicle screw insertion – Lumbar Fusion

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The article discusses the importance of determining the best entry point for a transpedicular procedure in spinal surgery. Various techniques have been used for this purpose, but the results have been inconsistent. The study utilized computer-aided design technology to determine the posterior endpoint of the lumbar pedicle central axis on standard anterior-posterior fluoroscopic images. The findings revealed that the projection point of the posterior endpoint was located superior to the X-axis and distributed in different sectors on the standard AP fluoroscopic image. This method could be helpful in selecting an entry point for a transpedicular procedure using fluoroscopic techniques

Summarised by Mr Mo Akmal – Lead Spinal Surgeon
The London Spine Unit : top day surgery hospital in UK

Published article

The transpedicular procedure has been widely used in spinal surgery. The determination of the best entry point is the key to perform a successful transpedicular procedure. Various techniques have been used to determine this point, but the results are variable. This study was carried out to determine the posterior endpoint of the lumbar pedicle central axis on the standard anterior-posterior (AP) fluoroscopic images. Computer-aided design technology was used to determine the pedicle central axis…

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Sci Rep. 2024 Apr 23;14(1):9272. doi: 10.1038/s41598-024-57349-8. ABSTRACT The transpedicular procedure has been widely used in spinal surgery. The determination of the best entry point is the key to perform a successful transpedicular procedure. Various techniques have been used to determine this point, but the results are variable. This study was carried out to determine,

Sci Rep. 2024 Apr 23;14(1):9272. doi: 10.1038/s41598-024-57349-8.

ABSTRACT

The transpedicular procedure has been widely used in spinal surgery. The determination of the best entry point is the key to perform a successful transpedicular procedure. Various techniques have been used to determine this point, but the results are variable. This study was carried out to determine the posterior endpoint of the lumbar pedicle central axis on the standard anterior-posterior (AP) fluoroscopic images. Computer-aided design technology was used to determine the pedicle central axis and the posterior endpoint of the pedicle central axis on the posterior aspect of the vertebra. The standard AP fluoroscopic image of the lumbar vertebral models by three-dimensional printing was achieved. The endpoint projection on the AP fluoroscopic image was determined in reference to the pedicle cortex projection by the measurements of the angle and distance on the established X-Y coordinate system of the radiologic image. The projection of posterior endpoint of the lumbar pedicle central axis were found to be superior to the X-axis of the established X-Y coordinate system and was located on the pedicle cortex projection on the standard AP fluoroscopic image of the vertebra. The projection point was distributed in different sectors in the coordinate system. It was located superior to the X-axis by 18° to 26° at L1, while they were located superior to the X-axis by 12° to 14° at L2 to L5. The projections of posterior endpoints of the lumbar pedicle central axis were located in different positions on the standard AP fluoroscopic image of the vertebra. The determination method of the projection point was helpful for selecting an entry point for a transpedicular procedure with a fluoroscopic technique.

PMID:38653756 | PMC:PMC11039741 | DOI:10.1038/s41598-024-57349-8

The London Spine Unit : top day surgery hospital in UK

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Posterior endpoint determination of the lumbar pedicle central axis on the anterior-posterior fluoroscopic image for pedicle screw insertion

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Sci Rep. 2024 Apr 23;14(1):9272. doi: 10.1038/s41598-024-57349-8. ABSTRACT The transpedicular procedure has been widely used in spinal surgery. The determination of the best entry point is the key to perform a successful transpedicular procedure. Various techniques have been used to determine this point, but the results are variable. This study was carried out to determine

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