ArticleJournal of orthopaedics and traumatology : official journal of the Italian Society of Orthopaedics and Traumatology2022
Intraoperative CT-guided navigation versus fluoroscopy for percutaneous pedicle screw placement in 192 patients: a comparative analysis.
Article in Journal of orthopaedics and traumatology : official journal of the Italian Society of Orthopaedics and Traumatology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 25 papers, 2 of them syntheses that pooled it.
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Who cites it
25 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Digital Twins and Health Care: an Umbrella Review.Journal of medical systems · 2025Pooled it
- Assessing the benefits of digital twins in neurosurgery: a systematic review.Neurosurgical review · 2024Pooled it
- Article
- Identification of a saddle point (SP) for safe sacral segment channel planning via data analysis and rapid physical prototyping.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 · 2026Article
- The global landscape of robot-assisted pedicle screws: a bibliometric and thematic evolution analysis.Journal of robotic surgery · 2026Review
- Robot-assisted pedicle screw placement in spinal surgery: an updated systematic umbrella review and meta-meta-analysis of comparisons against freehand and navigation-guided techniques.EFORT open reviews · 2026Article
- Time cost of the intraoperative CT in dorsal spinal fusion surgery in degenerative spinal disorders - a retrospective analysis of 518 degenerative cases.Brain & spine · 2026Article
- Statistical Surgical Process Modeling: Analysis of Workflow and Performance of Emerging Technologies in Image-Guided Spine Surgery.Annals of biomedical engineering · 2025Article
- Whole process navigated percutaneous endoscopic lumbar discectomy guided by a novel X-ray instant navigation: a technical report and preliminary clinical outcomes.BMC musculoskeletal disorders · 2025Article
- Influence of prone, supine, and lateral positions during spine surgery on vascular, abdominal, and postural anatomy: a comprehensive review and Bayesian meta-analysis.European journal of medical research · 2025Review
- Accuracy and Safety of Pedicle Screw Insertion Using Novel Intraoperative Computed Tomography Navigation System for Spinal Fusion Surgery.Spine surgery and related research · 2025Article
- Obturator inlet and iliac oblique fluoroscopic views allow for placement of longer iliac screws.North American Spine Society journal · 2025Article
- Article
- Intraosseous ultrasound for assessment of pedicle screw holes in the thoracolumbar spine based on endoscopic ultrasound: An experimental study.Acta neurochirurgica · 2025Article
- Current Trends and Future Directions in Lumbar Spine Surgery: A Review of Emerging Techniques and Evolving Management Paradigms.Journal of clinical medicine · 2025Review
- Intraoperative imaging adequacy and its impact on unplanned return-to-theatre rates in pedicle screw instrumentation.World journal of orthopedics · 2025Article
- Medical Digital Twin: A Review on Technical Principles and Clinical Applications.Journal of clinical medicine · 2025Review
- Combined vertebroplasty and pedicle screw insertion for vertebral consolidation: feasibility and technical considerations.Neuroradiology · 2024Article
- Pushing the Limits of Minimally Invasive Spine Surgery-From Preoperative to Intraoperative to Postoperative Management.Journal of clinical medicine · 2024Review
- [Precision and safety of positioning pedicle screws in the thoracic and lumbar spine using a hand-guided aiming sleeve : A CT control study].Unfallchirurgie (Heidelberg, Germany) · 2024Article
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Authors and funding
10 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundPercutaneous pedicle screw (PPS) placement is a key step in several minimally invasive spinal surgery (MISS) procedures. Traditional technique for PPS makes use of C-arm fluoroscopy assistance (FA). More recently, newer intraoperative imaging techniques have been developed for PPS, including CT-guided navigation (CTNav). The aim of this study was to compare FA and CTNav techniques for PPS with regard to accuracy, complications, and radiation dosage. MATERIALS AND
methodsA total of 192 patients with degenerative lumbar spondylolisthesis and canal stenosis who underwent MISS posterior fusion ± interbody fusion through transforaminal approach (TLIF) were retrospectively reviewed. Pedicle screws were placed percutaneously using either standard C-arm fluoroscopy guidance (FA group) or CT navigation (CTNav group). Intraoperative effective dose (ED, mSv) was measured. Screw placement accuracy was assessed postoperatively on a CT scan using Gertzbein and Robbins classification (grades A-E). Oswestry disability index (ODI) and visual analog scale (VAS) scores were compared in both groups before and after surgery.
resultsA total of 101 and 91 procedures were performed with FA (FA group) and CTNav approach (CTNav group), respectively. Median age was 61 years in both groups, and the most commonly treated level was L4-L5. Median ED received from patients was 1.504 mSv (0.494-4.406) in FA technique and 21.130 mSv (10.840-30.390) in CTNav approach (p < 0.001). Percentage of grade A and B screws was significantly higher for the CTNav group (96.4% versus 92%, p < 0.001), whereas there were 16 grade E screws in the FA group and 0 grade E screws in the CTNav group (p < 0.001). A total of seven and five complications were reported in the FA and CTNav group, respectively (p = 0.771).
conclusionsCTNav technique increases accuracy of pedicle screw placement compared with FA technique without affecting operative time. Nevertheless, no significant difference was noted in terms of reoperation rate due to screw malpositioning between CTNav and FA techniques. Radiation exposure of patients was significantly higher with CTNav technique. LEVEL OF EVIDENCE: Level 3.
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