10
views
0
recommends
+1 Recommend
1 collections
    0
    shares
      • Record: found
      • Abstract: found
      • Article: found
      Is Open Access

      True anteroposterior view pedicle screw insertion technique

      Read this article at

      ScienceOpenPublisherPMC
      Bookmark
          There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

          Abstract

          Background

          The wide use of minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) surgery in the treatment of degenerative disc disease of lumbar spine in spinal surgery highlights the gradual decrease in the use of traditional pedicle screw insertion technology. This study aims to analyze the accuracy of the true anteroposterior view pedicle screw insertion technique in MIS-TLIF surgery, compare it with conventional pedicle screw insertion technology, and discuss its clinical application value.

          Methods

          Fifty-two patients undergoing true anteroposterior view (group A) and 87 patients undergoing conventional pedicle screw insertion (group B) were diagnosed with lumbar disc herniation or lumbar spinal stenosis. Time for screw placement, intraoperative irradiation exposure, accuracy rate of pedicle screw insertion, and incidence of neurovascular injury were compared between the two groups.

          Results

          The time for screw placement and intraoperative irradiation exposure was significantly less in group A. Penetration rates of the paries lateralis of vertebral pedicle, medial wall of vertebral pedicle, and anterior vertebral wall were 1.44%, 0%, and 2.40%, respectively, all of which were significantly lower than that in group B. No additional serious complications caused by the placement of screw were observed during the follow-up period in patients in group A, but two patients with medial penetration underwent revision for unbearable radicular pain.

          Conclusion

          The application of true anteroposterior view pedicle screw insertion technique in MIS-TLIF surgery shortens time for screw placement and reduces the intraoperative irradiation exposure along with a higher accuracy rate of screw placement, which makes it a safe, accurate, and efficient technique.

          Related collections

          Most cited references 25

          • Record: found
          • Abstract: found
          • Article: not found

          Clinical and radiological outcomes of minimally invasive versus open transforaminal lumbar interbody fusion.

          Prospective study. Comparison of clinical and radiologic outcomes of minimally invasive (MIS) versus Open transforaminal lumbar interbody fusion (TLIF). Open TLIF has been performed for many years with good results. MIS TLIF techniques have recently been introduced with the aim of smaller wounds and faster recovery. From 2004-2006, 29 MIS TLIF were matched paired with 29 Open TLIF. Patient demographics and operative data were collected. Clinical assessment in terms of North American Spine Society, Oswestry Disability Index, Short Form-36, and Visual Analogue scores were performed before surgery, 6 months and 2 years after surgery. Fusion rates based on Bridwell grading were assessed at 2 years. The mean age for MIS and Open procedures were 54.1 and 52.5 years, respectively. There were 24 females and 5 males in both groups. Fluoroscopic time (MIS: 105.5 seconds, Open: 35.2 seconds, P 0.05). MIS TLIF has similar good long-term clinical outcomes and high fusion rates of Open TLIF with the additional benefits of less initial postoperative pain, early rehabilitation, shorter hospitalization, and fewer complications.
            Bookmark
            • Record: found
            • Abstract: found
            • Article: not found

            Minimally invasive versus open transforaminal lumbar interbody fusion: evaluating initial experience.

            The aim of this study was to compare our experience with minimally invasive transforaminal lumbar interbody fusion (MITLIF) and open midline transforaminal lumbar interbody fusion (TLIF). A total of 36 patients suffering from isthmic spondylolisthesis or degenerative disc disease were operated with either a MITLIF (n = 18) or an open TLIF technique (n = 18) with an average follow-up of 22 and 24 months, respectively. Clinical outcome was assessed using the visual analogue scale (VAS) and the Oswestry disability index (ODI). There was no difference in length of surgery between the two groups. The MITLIF group resulted in a significant reduction of blood loss and had a shorter length of hospital stay. No difference was observed in postoperative pain, initial analgesia consumption, VAS or ODI between the groups. Three pseudarthroses were observed in the MITLIF group although this was not statistically significant. A steeper learning effect was observed for the MITLIF group.
              Bookmark
              • Record: found
              • Abstract: found
              • Article: not found

              Comparative results between conventional and computer-assisted pedicle screw installation in the thoracic, lumbar, and sacral spine.

              A comparative study on the position of pedicle screws in patients treated surgically with and without computer assistance. To evaluate the accuracy of computer-assisted pedicle screw installation, and to evaluate its clinical benefit as compared with conventional pedicle screw installation techniques. In vitro and clinical studies have documented a significant rate of misplaced screws in the thoracolumbar area. Neurologic complications are recognized problems caused by screw misplacement. Patients treated surgically with computer assistance were compared with a historical control group of patients treated surgically with conventional techniques in the same hospital and by the same surgical team. All screw positions were measured with a postoperative magnetic resonance tomography, and cortical effractions were categorized in 2-mm increments. Patients' charts also were reviewed to assess individual neurologic outcomes. The control cohort was composed of 100 patients, with 544 screws from T5 to S1. The computer-assisted cohort was composed of 50 patients, with 294 screws from T2 to S1. In the control cohort, 461 of 544 screws (85%) were found completely within their pedicles as compared with 278 of 294 screws (95%) correctly placed in the computer-assisted group (P < 0.0001). All 16 screws incorrectly placed with computer assistance were found 0.1 mm to 2 mm from the pedicle cortex. In the control cohort, 68 screws were found 0.1 mm to 2 mm, 10 screws 2.1 mm to 4 mm, and 5 screws more than 4 mm from the pedicle cortex. Seven patients in the control cohort were surgically retreated because of postoperative neurologic deficits, whereas no patients in the computer-assisted group were surgically retreated. Computer assistance can decrease the incidence of incorrectly positioned pedicle screws.
                Bookmark

                Author and article information

                Journal
                Ther Clin Risk Manag
                Ther Clin Risk Manag
                Therapeutics and Clinical Risk Management
                Therapeutics and Clinical Risk Management
                Dove Medical Press
                1176-6336
                1178-203X
                2016
                29 June 2016
                : 12
                : 1039-1047
                Affiliations
                Key Biomechanical Laboratory of Orthopedics, The Third Hospital of Hebei Medical University, Shijiazhuang, Hebei, People’s Republic of China
                Author notes
                Correspondence: Wei Zhang, Key Biomechanical Laboratory of Orthopedics, The Third Hospital of Hebei Medical University, 139 Ziqiang Road, Shijiazhuang 050051, Hebei, People’s Republic of China, Tel +86 311 185 3311 2826, Email zwzw_zwei@ 123456163.com
                Article
                tcrm-12-1039
                10.2147/TCRM.S99362
                4935026
                27418828
                © 2016 Bai et al. This work is published and licensed by Dove Medical Press Limited

                The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License ( http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed.

                Categories
                Original Research

                Medicine

                true ap view, mis-tlif, pedicle screw, internal fixation, lumbar disc herniation

                Comments

                Comment on this article