Article
“Poor man’s navigation” – A simple method for the placement of pedicle screws in spinal standard instrumentation
“Poor man`s navigation” – eine simple Methode der Schraubenplatzierung bei Standardinstrumentationen
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Authors
Published: | April 23, 2004 |
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Outline
Text
Objective
Increasingly spinal image guided surgery is used for the placement of pedicle screws. However high costs and extended operation times result what ends in the question of its necessity. The accuracy of a simple method for the correct finding of the precise screw-entrance point in combination with tactile probing of the screw canal was examined retrospectively.
Methods
In 2001 57 patients were transpedicularly stabilised in 1-4 segments without computerised image guided surgery. Indications were fractures, spondylolisthesis, discitis and tumours. 58 screws (25%) were placed in the thoracic, 176 (75%) in the lumbar spine. The position of the screw was found out by computed tomography and classified as ideally, acceptable or displaced which resulted in a surgical revision.
Results
234 screws (96%) were placed perfectly. 3% (7 lumbar and 1 thoracic) were acceptable but not ideal because they perforated the lateral wall of the vertebra or pedicle. 2 thoracic screws crossed the spinal canal followed by surgical revision.
Conclusions
The presented non computerised navigation of thoracic and lumbar pedicle screws is accurate, incorrect screw placement is rare and it impresses by its low costs.