지원사업
학술연구/단체지원/교육 등 연구자 활동을 지속하도록 DBpia가 지원하고 있어요.
커뮤니티
연구자들이 자신의 연구와 전문성을 널리 알리고, 새로운 협력의 기회를 만들 수 있는 네트워킹 공간이에요.
논문 기본 정보
- 자료유형
- 학술저널
- 저자정보
- 발행연도
- 2016.1
- 수록면
- 630 - 638 (9page)
이용수
초록· 키워드
오류제보하기
Study Design: Retrospective. Purpose: This study aims to investigate the accuracy of the oblique fluoroscopic view, based on preoperative computed tomography (CT) images for accurate placement of lumbosacral percutaneous pedicle screws (PPS). Overview of Literature: Although PPS misplacement has been reported as one of the main complications in minimally invasive spine surgery, there is no comparative data on the misplacement rate among different fluoroscopic techniques, or comparing such techniques with open procedures. Methods: We retrospectively selected 230 consecutive patients who underwent posterior spinal fusion with a pedicle screw construct for degenerative lumbar disease, and divided them into 3 groups, those who had undergone: minimally invasive percutaneous procedure using biplane (lateral and anterior-posterior views using a single C-arm) fluoroscope views (group M-1), minimally invasive percutaneous procedure using the oblique fluoroscopic view based on preoperative CT (group M-2), and conventional open procedure using a lateral fluoroscopic view (group O: controls). The relative position of the screw to the pedicle was graded for the pedicle breach as no breach, <2 mm, 2–4 mm, or >4 mm. Inaccuracy was calculated and assessed according to the spinal level, direction and neurological deficit. Inter-group radiation exposure was estimated using fluoroscopy time. Results: Inaccuracy involved an incline toward L5, causing medial or lateral perforation of pedicles in group M-1, but it was distributed relatively equally throughout multiple levels in groups M-2 and controls. The mean fluoroscopy time/case ranged from 1.6 to 3.9 minutes. Conclusions: Minimally invasive lumbosacral PPS placement using the conventional fluoroscopic technique carries an increased risk of inaccurate screw placement and resultant neurological deficits, compared with that of the open procedure. Inaccuracy tended to be distributed between medial and lateral perforations of the L5 pedicle, as a result of pedicle morphology and the PPS pathway. Oblique fluoroscopic views, based on CT measurement, may allow accurate PPS insertion with a shorter fluoroscopy time.
목차
등록된 정보가 없습니다.
참고문헌 (4)
참고문헌 신청
Foley KT / 2002 / Percutaneous pedicle screw fixation of the lumbar spine: preliminary clinical results / J Neurosurg 97(1 Suppl):7~12
Ringel F / 2006 / Minimally invasive transmuscular pedicle screw fixation of the thoracic and lumbar spine / Neurosurgery 59(4 Suppl 2):ONS361~ONS366
Holly LT / 2003 / Three-dimensional fluoroscopyguided percutaneous thoracolumbar pedicle screw placement: technical note / J Neurosurg 99(3 Suppl):324~329
Schwender JD / 2005 / Minimally invasive transforaminal lumbar interbody fusion (TLIF): technical feasibility and initial results / J Spinal Disord Tech 18(Suppl):S1~S16
Ringel F / 2006 / Minimally invasive transmuscular pedicle screw fixation of the thoracic and lumbar spine / Neurosurgery 59(4 Suppl 2):ONS361~ONS366
Holly LT / 2003 / Three-dimensional fluoroscopyguided percutaneous thoracolumbar pedicle screw placement: technical note / J Neurosurg 99(3 Suppl):324~329
Schwender JD / 2005 / Minimally invasive transforaminal lumbar interbody fusion (TLIF): technical feasibility and initial results / J Spinal Disord Tech 18(Suppl):S1~S16
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