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
Pedicle screw insertion accuracy in terms of breach and reposition using a new intraoperative cone beam computed tomography imaging technique and evaluation of the factors associated with these parameters of accuracy: a series of 695 screws.
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 14 papers.
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14 citing papers in PubMed, 31 citations in OpenAlex.
- Off-Hours Robotic-Assisted Spine Instrumentation in a Teaching Hospital: Feasibility Under Increased Emergency and Workflow Burden.Journal of clinical medicine · 2026Article
- Implementation of Intraoperative Cone-Beam CT (Loop-X) in an Established Robotic-Assisted Pedicle Screw Program: An Epoch-Based Cohort Study.Journal of clinical medicine · 2026Article
- Combining Engineering Precision with Clinical Relevance: A Novel Dual Framework for Assessing Pedicle Screw Accuracy in Spine Surgery.Journal of clinical medicine · 2026Article
- Power-drill fluoroscopy-controlled technique as an alternative to navigation-assisted pedicle screw placement: A propensity score-matched retrospective cohort study.Brain & spine · 2026Article
- Low Radiation Protocol for Intraoperative Robotic C-Arm Can Enhance Adolescent Idiopathic Scoliosis Deformity Correction Accuracy and Safety.Global spine journal · 2024Article
- Is the postoperative pedicle screw position after dorsal instrumentation with or without intraoperative cone beam CT imaging worse in patients with obesity than in normal-weight patients?Journal of orthopaedic surgery and research · 2022Article
- CT-Navigated Spinal Instrumentations-Three-Dimensional Evaluation of Screw Placement Accuracy in Relation to a Screw Trajectory Plan.Medicina (Kaunas, Lithuania) · 2022Article
- Use of a Customized Three-dimensional Guide in Preparing the Pilot Pedicle Hole in Spinal Deformities.Revista brasileira de ortopedia · 2022Article
- Evaluation of the accuracy of mobile cone-beam computed tomography after spinal instrumentation surgery.Journal of trauma and injury · 2022Article
- Perspective on the integration of optical sensing into orthopedic surgical devices.Journal of biomedical optics · 2022Article
- Intraoperative 3D imaging with cone-beam computed tomography leads to revision of pedicle screws in dorsal instrumentation: a retrospective analysis.Journal of orthopaedic surgery and research · 2021Article
- Breach Rate Analysis of Pedicle Screw Instrumentation using Free-Hand Technique in the Surgical Correction of Adolescent Idiopathic Scoliosis.Journal of orthopaedic case reports · 2021Article
- Intraoperative CT and cone-beam CT imaging for minimally invasive evacuation of spontaneous intracerebral hemorrhage.Acta neurochirurgica · 2020Article
- Navigated percutaneous versus open pedicle screw implantation using intraoperative CT and robotic cone-beam CT imaging.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 · 2020Article
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Authors and funding
6 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeThe goals of this study were to assess the accuracy of pedicle screw insertion using an intraoperative cone beam computed tomography (CBCT) system, and to analyze the factors potentially influencing this accuracy.
methodsSix hundred and ninety-five pedicle screws were inserted in 118 patients between October 2013 and March 2016. Screw insertion was performed using 2D-fluoroscopy or CBCT-based navigation. Accuracy was assessed in terms of breach and reposition. All the intraoperative CBCT scans, done after screw insertion, were reviewed to assess the accuracy of screw placement using two established classification systems: Gertzbein and Heary. Generalized linear mixed models were used to model the odds (95% CI) for a screw to lead to a breach according to the independent variables.
resultsThe breach rate was 11.7% using the Gertzbein classification and 15.4% using the Heary classification. Seventeen screws (2.4%) were repositioned intraoperatively. The only factor affecting statistically the odds to have a breach was the indication of surgery. The patients with non-degenerative disease had a significantly higher risk of breach than those with degenerative disease.
conclusionUse of intraoperative CBCT as 2D-fluoroscopy or coupled with a navigation system for pedicle screw insertion is accurate in terms of breach occurrence and reposition. However, these rates depend on the classification or grading system used. Use of a navigation system does not decrease the risk of breach significantly. And the risk of breach is higher in non-degenerative conditions (trauma, scoliosis, infection, and malignancy disease) than in degenerative diseases.
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