Evidence map›Paper›PMID 25971356›Full record

ArticleEuropean spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society2017

Rotation effect and anatomic landmark accuracy for midline placement of lumbar artificial disc under fluoroscopy.

Mark Mikhael, Jaysson T Brooks, Yusuf T Akpolat, Wayne K Cheng

Abstract read
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In one paragraph

Article in European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
0.2field-weighted citation impact, top 44% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 3 citations in OpenAlex.

  1. Article
  2. Accuracy of various fluoroscopic landmarks for determination of midline implant placement within the cervical disc space.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2021
    Article
  3. We Need to Talk about Lumbar Total Disc Replacement.International journal of spine surgery · 2018
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors at 2 institutions in 1 country.

Mark MikhaelDepartment of Orthopaedic Surgery, School of Medicine, Loma Linda University, 11406 Loma Linda Dr, Suite 213, Loma Linda, CA, 92354, USA.
Jaysson T BrooksDepartment of Orthopedic Surgery, Johns Hopkins Hospital, Baltimore, MD, USA.
Yusuf T AkpolatDepartment of Orthopaedic Surgery, School of Medicine, Loma Linda University, 11406 Loma Linda Dr, Suite 213, Loma Linda, CA, 92354, USA.
Wayne K ChengDepartment of Orthopaedic Surgery, School of Medicine, Loma Linda University, 11406 Loma Linda Dr, Suite 213, Loma Linda, CA, 92354, USA. md4spine@yahoo.com.
Loma Linda University · USJohns Hopkins Hospital · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeTotal disc arthroplasty can be a viable alternative to fusion for degenerative disc disease of the lumbar spine. The correct placement of the prosthesis within 3 mm from midline is critical for optimal function. Intra-operative radiographic error could lead to malposition of the prosthesis. The objective of this study was first to measure the effect of fluoroscopy angle on the placement of prosthesis under fluoroscopy. Secondly, determine the visual accuracy of the placement of artificial discs using different anatomical landmarks (pedicle, waist, endplate, spinous process) under fluoroscopy.

methodsArtificial discs were implanted into three cadaver specimens at L2-3, L3-4, and L4-L5. Fluoroscopic images were obtained at 0°, 2.5°, 5°, 7.5°, 10°, and 15° from the mid axis. Computerized tomography (CT) scans were obtained after the procedure. Distances were measured from each of the anatomic landmarks to the center of the implant on both fluoroscopy and CT. The difference between fluoroscopy and CT scans was compared to evaluate the position of prosthesis to each anatomic landmark at different angles.

resultsThe differences between the fluoroscopy to CT measurements from the implant to pedicle was 1.31 mm, p < 0.01; implant to waist was 1.72 mm, p < 0.01; implant to endplate was 1.99 mm, p < 0.01; implant to spinous process was 3.14 mm, p < 0.01. When the fluoroscopy angle was greater than 7.5°, the difference between fluoroscopy and CT measurements was greater than 3 mm for all landmarks.

conclusionsA fluoroscopy angle of 7.5° or more can lead to implant malposition greater than 3 mm. The pedicle is the most accurate of the anatomic landmarks studied for placement of total artificial discs in the lumbar spine.

Indexed as

Anatomic LandmarksIntervertebral DiscLumbar VertebraeFluoroscopyHumansProstheses and ImplantsRotationSurgery, Computer-AssistedTotal Disc ReplacementAccuracyArtificial discFluoroscopic guidanceMalpositionTotal disc replacement

Identifiers

PMID25971356
OpenAlexW222205080

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.