Evidence map›Paper›PMID 27844228›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

Accuracy of a dynamic surgical guidance probe for screw insertion in the cervical spine: a cadaveric study.

Daniel Dixon, Bruce Darden, Jose Casamitjana, Karen A Weissmann, San Cristobal, David Powell, Daniel Baluch

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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 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
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

4 citing papers in PubMed.

  1. Review
  2. Article
  3. Article
  4. [Treatment of tuberculosis in craniovertebral junction].Zhongguo xiu fu chong jian wai ke za zhi = Zhongguo xiufu chongjian waike zazhi = Chinese journal of reparative and reconstructive surgery · 2020
    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

7 authors.

Daniel Dixon, 2001 Randolph Rd, Charlotte, NC, 28207, USA.
Bruce DardenOrthoCarolina Spine Center, Attn: Annette Wilson, 2001 Randolph Rd, Charlotte, NC, 28207, USA. bruce.darden@orthocarolina.com.
Jose Casamitjana, Av. Diagonal 491, 6º1ª, 08029, Barcelona, Spain.
Karen A WeissmannSpine Surgery Unit, Hospital Exequiel Gonzalez Cortés, Clínica Bicentenario, Clinica Avansalud and Fundación Médica, Santiago, Chile.
San CristobalOrthopedic Surgery Department, Universidad de Chile, Santiago, Chile.
David PowellFort Wayne Radiology, 3707 New Vision Drive, Fort Wayne, IN, 46845, USA.
Daniel Baluch, 2001 Randolph Rd, Charlotte, NC, 28207, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

STUDY

designA fresh frozen cadaver study was conducted.

objectiveTo report the cortical breach rate using the dynamic surgical guidance (DSG) probe versus traditional freehand technique for cervical lateral mass, cervical pedicle and cervical laminar screws.

methodsNine male fresh frozen cadaveric torsos were utilized for this study. Each investigator was assigned three specimens that were randomized by fixation point, side and order of technique for establishing a screw pilot hole. The technique for screw hole preparation utilized was either a DSG probe in the "on" mode or in the "off" mode using a freehand technique popularized by Lenke et al. Levels instrumented included C1 lateral mass, C2 pedicle screws and lamina screws, and C6-T1 pedicle screws. Fluoroscopy and other navigational assistance were not used for screw hole preparation or screw insertion. All specimens were CT imaged following insertion of all screws. A senior radiologist evaluated all scans and determined that a misplaced screw was a breach of ≥2 mm.

resultsA total of 104 drillings were performed, 52 with DSG and 52 without DSG There were 68 total pedicle drillings, 34 in each group. There were 18 drillings in the lamina and lateral mass. There was no significant difference between surgeons or between the left and right side. All breaches were in the pedicle, and none in the lamina or lateral mass. The breach rate for PG "on" was 6/68 = 8.96% (95% CI 3.69, 19.12%). The breach rate for PG "off" was 20/68 = 29.41% (95% CI 19.30, 41.87%). Of the 20 pedicle breaches in the non-DSG group, 7 were lateral and superior, 8 were lateral, 4 medial and 1 inferior. Of the six pedicle breaches in the DSG group, two were lateral/superior, two were lateral and two were medial in the pedicle.

conclusionsThe dynamic surgical guidance probe is a safe tool to assist the surgeon with screw placement in the cervical spine. Additionally, the DSG potentially avoids the cumulative risks associated with fluoroscopy and provides real-time feedback to the surgeon allowing correction at the time of breach. Level of evidence Level IV.

Indexed as

Cervical VertebraePedicle ScrewsHumansMaleRandom AllocationSpinal FusionSurgery, Computer-AssistedTomography, X-Ray ComputedC2 pedicle screwC7 pedicle screwCervical spineCortical breachDynamic surgical guidanceElectrical conductivityFluoroscopyLamina screwLateral massLateral mass screw

Identifiers

PMID27844228

What OpenQuestion holds

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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.