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학제간연구 과학기술학 뇌인지과학 기술정책 기타 복합학

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논문 기본 정보

자료유형
학술저널
저자정보
Conor Dunn (Seton Hall University School of Health and Medica) Michael Faloon (Seton Hall University School of Health and Medica) Edward Milman (Seton Hall University School of Health and Medica) Sina Pourtaheri (University of California Los Angeles) Kumar Sinah (Seton Hall University School of Health and Medica) Ki Hwang (Seton Hall University School of Health and Medica) Arash Emami (Seton Hall University School of Health and Medica)
저널정보
대한척추외과학회 Asian Spine Journal Asian Spine Journal Vol.12 No.2
발행연도
2018.1
수록면
238 - 245 (8page)

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초록· 키워드

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Study Design: Retrospective case series with prospective arm. Purpose: To assess the safety and accuracy of percutaneous lumbosacral pedicle screw placement (PLPSP) in the lumbosacral spine using intraoperative dual-planar fluoroscopy (DPF). Overview of Literature: There are several techniques available for achieving consistent, safe, and accurate results with PLPSP. There is a paucity of literature describing the beneficial operative, economic, and clinical outcomes of DPF, the most readily accessible image guidance system. Methods: From 2004 to 2014, 451 consecutive patients underwent PLPSP using DPF, for a total of 2,345 screw placement. The results of prospectively obtained postoperative computed tomography (CT) examinations of an additional 41 consecutive patients were compared with the results of 104 CT examinations obtained postoperatively due to clinical symptomatology; these results were interpreted by three reviewers. The rates of revision indicated by misplaced screws with consistent clinical symptomatology were compared between groups. Pedicle screw placement was graded according to 2-mm increments in medial pedicle wall breach and measurement of screw axis placement. Results: Seven of the 2,345 pedicle screws placed percutaneously with the use of the dual-planar fluoroscopic technique required revision because of a symptomatic misplaced screw, for a screw revision rate of 0.3%. There were no statistically significant demographic differences between patients who had screws revised and those who did not. All screws registered greater than 10 mA on electromyographic stimulation. In the 41 prospectively obtained CT examinations, one out of 141 screws (0.7%) was revised due to pedicle wall breach; whereas among the 104 patients with 352 screws, three screws were revised (0.9%). Conclusions: DPF is an extremely accurate, safe, and reproducible technique for placement of percutaneous pedicle screws and is a readily available and cost-effective alternative to CT-guided pedicle screw placement techniques. Postoperative CT evaluation is not necessary with PLPSP unless the patient is symptomatic. Acceptable electromyographic thresholds may need to be reevaluated.

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참고문헌 (30)

참고문헌 신청
Scheufler KM / 2007 / Percutaneous transforaminal lumbar interbody fusion for the treatment of degenerative lumbar instability / Neurosurgery 60(4 Suppl 2):203~212 Crossref Kosmopoulos V / 2007 / Pedicle screw placement accuracy: a meta-analysis / Spine (Phila Pa 1976) 32:E111~E120 Crossref Foley KT / 2002 / Percutaneous pedicle screw fixation of the lumbar spine: preliminary clinical results / J Neurosurg 97(1 Suppl):7~12 google schola Aoude AA / 2015 / Methods to determine pedicle screw placement accuracy in spine surgery: a systematic review / Eur Spine J 24:990~1004 Crossref Chapman TM / 2016 / CT accuracy of percutaneous versus open pedicle screw techniques: a series of 1609 screws / Eur Spine J 25:1781~1786 Crossref

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