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Redirecting pedicle screws: a revision spinal fusion strategy using three‐dimensional image guidance
Author(s) -
Yoon Jang W.,
Nottmeier Eric W.,
Rahmathulla Gazanfar,
Fenton Douglas S.,
Pirris Stephen M.
Publication year - 2016
Publication title -
the international journal of medical robotics and computer assisted surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.556
H-Index - 53
eISSN - 1478-596X
pISSN - 1478-5951
DOI - 10.1002/rcs.1721
Subject(s) - medicine , cone beam computed tomography , cone beam ct , fixation (population genetics) , bony fusion , grading (engineering) , spinal fusion , image fusion , surgery , orthodontics , computed tomography , radiography , computer science , artificial intelligence , image (mathematics) , population , civil engineering , environmental health , engineering
Background Pedicle screws are a preferred method for spinal fixation because of their three‐column support and rigid posterior stabilization. The purpose of this study was to evaluate the outcome of patients requiring pedicle screw redirection, and to describe a technique using cone‐beam computed tomography (cbCT). Methods A retrospective review of 30 patients undergoing revision spinal fusion with redirection of pedicle screws was performed. Fifty pedicle screws were redirected in these patients using cbCT‐based 3D image guidance. They were graded pre‐ and post‐operatively using an established grading system. Results No complications occurred in this study as a result of redirection. No pedicle breach was noted in all of the redirected pedicle screws. Conclusion Redirection of misplaced pedicle screws using cbCT‐based 3D image guidance seems to be safe and accurate in our experience. Further studies are needed to establish its safety, accuracy, fusion rate, and clinical outcome compared with other methods. Copyright © 2016 John Wiley & Sons, Ltd.