Article
Factors of influence upon flouroscopy duration in thoraco-lumbar dorsal stabilisation with pedicle screws
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Authors
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Bogdan Pintea
- Klinik und Poliklinik für Neurochirurgie, Universitätsklinikum Bonn
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T. Vassiliou
- Klinik und Poliklinik für Neurochirurgie, Universitätsklinikum Bonn
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Matthias Geiger
- Klinik und Poliklinik für Neurochirurgie, Universitätsklinikum Bonn; Neurochirurgische Klinik, Universitätsklinikum Aachen
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Martin Podlogar
- Klinik und Poliklinik für Neurochirurgie, Universitätsklinikum Bonn
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Christian-A. Müller
- Klinik und Poliklinik für Neurochirurgie, Universitätsklinikum Bonn; Neurochirurgische Klinik, Universitätsklinikum Aachen
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Rudolf A. Kristof
- Klinik und Poliklinik für Neurochirurgie, Universitätsklinikum Bonn
| Published: | June 2, 2015 |
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| Published with erratum: | June 9, 2015 |
Outline
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Objective: To evaluate the factors of influence upon fluoroscopy duration during thoraco-lumbar dorsal stabilisation with pedicle screw insertion.
Method: For all patients (n=473) treated by dorsal stabilisation with pedicle screw insertion in the thoraco-lumbar spine during a period of 7 years, the fluoroscopy duration was prospectively documented. Other population characteristics like: gender, age, body mass index (BMI), pathology, as well as surgical characteristics like: site of screw implantation, physicians' experience and blood loss, were retrospectively collected out of the patients' charts. The fluoroscopy duration per screw was than related to these potential factors of influence.
Results: The mean fluoroscopy time per screw was 1,4 minutes (min): the shortest mean fluoroscopy time was found for the 7th thoracic vertebra (1,3 min) and the longest mean fluoroscopy time for the first thoracic vertebra (2,1 min); however these findings did not differ significantly. Longer fluoroscopy per screw was needed in traumatic diseases (1,6 min), followed by tumor (1,5 min), degenerative (1,4 min) and infectious (1,3 min) spine diseases. Higher volumen spine surgeons need less time for fluoroscopy (1,2 min vs. 2,3 min, p=0,062). The fluoroscopy time was longer in female patients, age > 75 years, BMI > 25 and in patients with a higher intraoperative blood loss. However, only age > 75 years was of statistical significant influence upon the fluoroscopy time (p=0,039). In the multivariate analysis of the data, patients' age and higher volume spine surgeons influenced fluoroscopy duration significantly (p=0,037) or with a trend to significancy (p=0,064).
Conclusions: Patients age > 75 years and surgeons experience were the only significant and trendwise significant factors of influence upon fluoroscopy duration in the univariate and multivariate analysis. Gender, the level of screw placement, the type of spinal disease, and higher intraoperative blood loss might be other potential factors of influence. However they do not reach statistical significancy in our study.
