Journal Information
Vol. 21. Issue 4.
Pages 306-311 (January 2010)
Share
Share
Download PDF
More article options
Vol. 21. Issue 4.
Pages 306-311 (January 2010)
Fiabilidad del navegador en la colocación de tornillos pediculares toracolumbares
Accuracy of pedicle screw insertion in the thoracolumbar spine using image-guided navigation
Visits
1831
S. Fuster
Corresponding author
sfuster@clinic.ub.es

Correspondencia: Obregón. Unitat de Raquis. Hospital Clínic. Universitat de Barcelona. Villarroel 170, Escala 12, planta 0. 08036 Barcelona. España
, A. Vega, G. Barrios, I. Urdaneta, O. Ojeda, M. Macchia, A. Combalia, J. Berenguer, T. Pujol
Unitat de Raquis. Hospital Clínic. Universitat de Barcelona
This item has received
Article information
Resumen
Introducción

La cirugía guiada por imagen es uno de los más importantes avances tecnológicos dentro de la cirugía del Raquis ya que permite al cirujano realizar una navegación multiplanar tridimensional en tiempo real en el interior de una vértebra.

Material y métodos

Realizamos un estudio clínico prospectivo no randomizado sobre la fiabilidad en la colocación de tornillos pediculares mediante un sistema de navegación optoelectrónico (SurgiGATE Spine 2.1 Medivision). Se estudiaron veintinueve pacientes intervenidos por diferentes patologías en columna toracolumbar incluyendo: degenerativas (54%), espondilolistesis (21%), fracturas (14%), escoliosis (7%) y espondilodiscitis (4%). Un paciente fue eliminado del estudio debido a un fallo técnico en el equipo de navegación. Se obtuvieron imágenes de TC pre y postoperatorias de cada paciente y éstas fueron evaluadas por dos neurorradiólogos independientes. La colocación correcta se definió de acuerdo a la escala de Heary en 5 grados.

Resultados

Se colocaron 163 tornillos, 29 en la columna toracolumbar y 134 en la columna lumbosacra. Hemos conseguido una colocación totalmente intraósea (Grado I) en el 99,4% de tornillos en la columna lumbosacra y en un 100% en la columna toracolumbar. Se comprobó el error de colocación (Grado III) en un pedículo de L3 en la concavidad de una escoliosis. No se observaron complicaciones relacionadas con los implantes.

Conclusiones

El bajo porcentaje de tornillos mal colocados en este estudio se compara favorablemente con los resultados publicados en la literatura. Nuestros resultados indican que la cirugía guiada por imagen aplicada a la cirugía del raquis es una técnica segura para la fijación transpedicular.

Palabras clave:
Fiabilidad
Navegador
Tornillos pediculares
Toracolumbar
Abreviaturas:
TC
RM
2D
Summary
Introduction

Computer image guidance is one of the most significant technologic advancements in the spine surgery, because preoperative or intraoperative images can be used for multiplanar, three-dimensional intraoperative navigation.

Material and methods

We performed a prospective clinical study to assess the accuracy of pedicle screw insertion using an optoelectronic navigation system (SurgiGATE Spine 2.1 Medivision). The study population included 29 patients with diverse disorders of the thoraco-lumbar spine (degenerative 54%, spondylolisthesis 21%, fractures 14%, scoliosis 7% and spondylodiscitis 4%). One patient was excluded from the study because problems with the specific instruments or the computer system. Pre and post-operative axial computed tomography images were obtained for each patient and analyzed by two independent radiologists to placement accuracy. The correct location was defined accord to Heary scale in 5 grades.

Results

163 image-guided thoraco-lumbar pedicle screws were placed 29 in the thoracolumbar spine and 134 in the lumbosacral spine. We achieved a completely intraosseous placement (Grade I) in 99.4% of lumbosacral spine screws and 100% of thoracolumbar spine screws. Only one misplaced screw (Grade III) in the pedicle of L III in the concavity of a scoliosis was reported. No implant related complications were noted.

Conclusions

The low rate of misplaced screws in this prospective study compares favorably with previously published results. Our initial results indicate that Image-guided spinal surgery is a safe technique which improves surgical performance during posterior transpedicle stabilization.

Key words:
Accuracy
Navigation
Pedicle screw
Thoraco-lumbar spine

Article

These are the options to access the full texts of the publication Neurocirugía (English edition)
Member
Member of the Sociedad Española de Neurocirugía

If it is the first time you have accessed you can obtain your credentials by contacting Elsevier Spain in suscripciones@elsevier.com or by calling our Customer Service at902 88 87 40 if you are calling from Spain or at +34 932 418 800 (from 9 to 18h., GMT + 1) if you are calling outside of Spain.

If you already have your login data, please click here .

If you have forgotten your password you can you can recover it by clicking here and selecting the option ¿I have forgotten my password¿.

Subscriber
Subscriber

If you already have your login data, please click here .

If you have forgotten your password you can you can recover it by clicking here and selecting the option “I have forgotten my password”
Subscribe
Subscribe to

Neurocirugía (English edition)

Purchase
Purchase article

Purchasing article the PDF version will be downloaded

Price 19.34 €

Purchase now
Contact
Phone for subscriptions and reporting of errors
From Monday to Friday from 9 a.m. to 6 p.m. (GMT + 1) except for the months of July and August which will be from 9 a.m. to 3 p.m.
Calls from Spain
932 415 960
Calls from outside Spain
+34 932 415 960
Email
Idiomas
Neurocirugía (English edition)
Article options
Tools
es en

¿Es usted profesional sanitario apto para prescribir o dispensar medicamentos?

Are you a health professional able to prescribe or dispense drugs?