gms | German Medical Science

71. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC)
9. Joint Meeting mit der Japanischen Gesellschaft für Neurochirurgie

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

21.06. - 24.06.2020

Article

Send article

Pedicle screw insertion accuracy using intraoperative computed tomography image-guided navigation – a series of 608 screws

Genauigkeit beim Einsetzen von bildgestützt navigierten Pedikelschrauben mithilfe der intraoperativen Computertomographie – eine Serie von 608 Schrauben

Meeting Abstract

Search Medline for

  • presenting/speaker Bastian Stemmer - Universitätsklinikum Augsburg, Klinik für Neurochirurgie, Augsburg, Deutschland
  • Benedikt Trnovec - Universitätsklinikum Augsburg, Klinik für Neurochirurgie, Augsburg, Deutschland
  • Ehab Shiban - Universitätsklinikum Augsburg, Klinik für Neurochirurgie, Augsburg, Deutschland
  • Volkmar Heidecke - Universitätsklinikum Augsburg, Klinik für Neurochirurgie, Augsburg, Deutschland

Deutsche Gesellschaft für Neurochirurgie. 71. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), 9. Joint Meeting mit der Japanischen Gesellschaft für Neurochirurgie. sine loco [digital], 21.-24.06.2020. Düsseldorf: German Medical Science GMS Publishing House; 2020. DocP038

doi: 10.3205/20dgnc329, urn:nbn:de:0183-20dgnc3290

Published: June 26, 2020

© 2020 Stemmer et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.

Outline

Text

Objective: The goals of this study were to assess the accuracy of pedicle screw insertion using an intraoperative computed tomography (iCT), and to analyze potential risk factors for screw misplacement.

Methods: A retrospective analysis of all patients following iCT navigated spinal pedicle screw placement between November 2016 and February 2019 was performed. Navigated drilling of the pedicle was followed by screw placement. Screw position was checked by a further iCT scan . Screw position was assesed according to the Gertzbein-Robbins classification.

Results: 109 consecutive patients were identified (52,3 % male, 47,7 % female). Median age was 71 years. Screws were placed in all spinal regions : cervical and cervico-thoracal (68), thoracic (118), thoracic-lumbar (126), lumbar (206) and lumbosacral (90). Degenerative spine disease was the most common diagnosis (49,0%). There were 75,3%, 12,0%, 7,4%, 2,5% and 3,1% screws classified as Gertzbein-Robbins A, B, C, D and E , respectively. 30 screws (4,93%) were revised intraoperatively. Lumbar spine, thoracic spine, tumor and infection diagnosis were associated with highest rates of screw misplacement. None of the patients suffered from any neurovascular damage.

Conclusion: The all-over revision rate was 4,93%. The highest revision rates were observed for tumor (6,38 %), infection patients (6,86 %), lumbar spine (6,30 %) and thoracic spine (5,90 %). None of the patients suffered from any neurovascular damage. No secondary operation to revise the misplaced screws was required.