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The accuracy of cortical bone trajectory screw placement guided by spinous process clamp hardware in lumbar spinal surgery: a retrospective study – Lumbar Fusion

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This article assesses the accuracy of cortical bone trajectory (CBT) screw placement in single-level midline lumbar fusion (MIDLF) surgery using a spinous process clamp (SPC) guide. The study included 32 patients who underwent the surgery and were divided into two groups: free-hand (FH) and SPC-guided. The results showed that the SPC group had higher rates of clinically acceptable screw placement and grade A screws compared to the FH group. Misplacement of screws and proximal facet joint violation were also lower in the SPC group. The radiation dose and time were comparable between the two groups, but the operative time was longer in the SPC group. Other clinical parameters did not show significant differences. Overall, SPC-guided screw placement was found to be more accurate than the fluoroscopy-assisted FH technique for single-level MIDLF. Both groups achieved similar clinical outcomes in terms of improvement in disability index and back pain

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Published article

This study aimed to assess the accuracy of cortical bone trajectory (CBT) screws placement guided by a spinous process clamp (SPC) guide. A total of 32 patients who received single-level midline lumbar fusion (MIDLF) surgery between June 2019 and January 2020 were retrospectively analyzed and divided into free-hand (FH) and SPC-guided groups according to the surgical approach. In the FH group, CBT screws was implanted with the assistance of fluoroscopy, while in the SPC group, CBT screws was…

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Sci Rep. 2023 Sep 30;13(1):16447. doi: 10.1038/s41598-023-43406-1.ABSTRACTThis study aimed to assess the accuracy of cortical bone trajectory (CBT) screws placement guided by a spinous process clamp (SPC) guide. A total of 32 patients who received single-level midline lumbar fusion (MIDLF) surgery between June 2019 and January 2020 were retrospectively analyzed and divided into free-hand (FH),

Sci Rep. 2023 Sep 30;13(1):16447. doi: 10.1038/s41598-023-43406-1.

ABSTRACT

This study aimed to assess the accuracy of cortical bone trajectory (CBT) screws placement guided by a spinous process clamp (SPC) guide. A total of 32 patients who received single-level midline lumbar fusion (MIDLF) surgery between June 2019 and January 2020 were retrospectively analyzed and divided into free-hand (FH) and SPC-guided groups according to the surgical approach. In the FH group, CBT screws was implanted with the assistance of fluoroscopy, while in the SPC group, CBT screws was implanted using the SPC navigator hardwire. A total of 128 screws were assessed in this study, with higher rates of clinically acceptable screw placement (grades A and B) and grade A screws in the SPC group than in the FH guide group (92.2% vs. 79.7%, P = 0.042 and 54.7% vs. 35.9%, P = 0.033, respectively). Misplacement screws (grades C, D, and E) occurred more often in the FH group than in the SPC guide group (20.3% vs. 7.8%, P = 0.042). The incidence of proximal facet joint violation (FJV) was higher in the FH group than in the SPC group (15.6% vs. 3.1%, P = 0.030). The radiation dose and time in the SPC guide group were comparable to those in the FH group (P = 0.063 and P = 0.078). The average operative time was significantly longer in the SPC guide group than in the FH group (267.8 ± 45.5 min vs. 210.9 ± 44.5 min, P = 0.001). Other clinical parameters, such as the average bone mineral density (BMD), intraoperative blood loss, and postoperative hospital stay, were not significantly different. Oswestry disability index (ODI) and back pain visual analogue scale (VAS) scores were significantly improved in both groups compared with preoperatively. SPC guided screw placement was more accurate than the fluoroscopy-assisted FH technique for single-level MIDLF at L4/5. Patients undergoing SPC-guided screw placement can achieve similar clinical outcomes as the fluoroscopy-assisted FH technique.

PMID:37777594 | DOI:10.1038/s41598-023-43406-1

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The accuracy of cortical bone trajectory screw placement guided by spinous process clamp hardware in lumbar spinal surgery: a retrospective study

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Sci Rep. 2023 Sep 30;13(1):16447. doi: 10.1038/s41598-023-43406-1.ABSTRACTThis study aimed to assess the accuracy of cortical bone trajectory (CBT) screws placement guided by a spinous process clamp (SPC) guide. A total of 32 patients who received single-level midline lumbar fusion (MIDLF) surgery between June 2019 and January 2020 were retrospectively analyzed and divided into free-hand (FH)

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