Evidence map›Paper›PMID 37373646›Full record

ArticleJournal of clinical medicine2023

The Child's Age and the Size of the Curvature Do Not Affect the Accuracy of Screw Placement with the Free-Hand Technique in Spinal Deformities in Children and Adolescents.

Pawel Grabala, Ilkka J Helenius, Piotr Kowalski, Michal Grabala, Slawomir Zacha, Jaroslaw M Deszczynski, Tomasz Albrewczynski, Michael A Galgano, Jacob M Buchowski, Kelly Chamberlin and 1 more

Open access · goldAbstract read
In one paragraph

Article in Journal of clinical medicine, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.

0numbers the graph read from it
0cells of the map it votes in
10citing papers in PubMed
2.5field-weighted citation impact, top 11% 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

10 citing papers in PubMed, 8 citations in OpenAlex.

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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

11 authors at 7 institutions in 3 countries.

Pawel GrabalaDepartment of Pediatric Orthopedic Surgery and Traumatology, University Children's Hospital, Medical University of Bialystok, Waszyngtona 17, 15-274 Bialystok, Poland.ORCID 0000-0001-7059-2935
Ilkka J HeleniusDepartment of Orthopedics and Traumatology, Helsinki University Hospital, 00260 Helsinki, Finland.ORCID 0000-0001-5200-3279
Piotr KowalskiDepartment of Neurosurgery, Regional Specialized Hospital, Ul. Dekerta 1, 66-400 Gorzow Wielkopolski, Poland.
Michal Grabala2nd Clinical Department of General and Gastroenterogical Surgery, Medical University of Bialystok, Ul. Marii Skłodowskiej-Curie 24a, 15-276 Bialystok, Poland.
Slawomir ZachaDepartment of Pediatric Orthopedics and Oncology of the Musculoskeletal System, Pomeranian Medical University in Szczecin, 71-252 Szczecin, Poland.
Jaroslaw M DeszczynskiPaley European Institute, Al. Rzeczypospolitej 1, 02-972 Warsaw, Poland.ORCID 0000-0003-2227-147X
Tomasz AlbrewczynskiPaley European Institute, Al. Rzeczypospolitej 1, 02-972 Warsaw, Poland.
Michael A GalganoDepartment of Neurosurgery, University of North Carolina, Chapel Hill, NC 27516, USA.
Jacob M BuchowskiDepartment of Orthopedic Surgery, Washington University School of Medicine, 660 S Euclid Ave., St. Louis, MO 63110, USA.
Kelly ChamberlinDepartment of Neurosurgery, University of North Carolina, Chapel Hill, NC 27516, USA.ORCID 0000-0002-3596-4825
Suken A ShahDepartment of Orthopaedic Surgery, Nemours Children's Health, Delaware Valley,1600 Rockland Road, Wilmington, DE 19803, USA.
Medical University of Białystok · PLUniversity of North Carolina at Chapel Hill · USHelsinki University Hospital · FIMedical University of Warsaw · PLNemours Children's Health System · USPomeranian Medical University · PLWashington University in St. Louis · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe current method of treatment of spinal deformities would be almost impossible without pedicle screws (PS) placement. There are only a few studies evaluating the safety of PS placement and possible complications in children during growth. The present study was carried out to evaluate the safety and accuracy of PS placement in children with spinal deformities at any age using postoperative computed tomography (CT) scans.

methods318 patients (34 males and 284 females) who underwent 6358 PS fixations for pediatric spinal deformities were enrolled in this multi-center study. The patients were divided into three age groups: less than 10 years old, 11-13 years old, and 14-18 years old. These patients underwent postoperative CT scans and were analyzed for pedicle screw malposition (anterior, superior, inferior, medial, and lateral breaches).

resultsThe breach rate was 5.92% for all pedicles. There were 1.47% lateral and 3.12% medial breaches for all pedicles with tapping canals, and 2.66% lateral and 3.84% medial breaches for all pedicles without a tapping canal for the screw. Of the 6358 screws placed in the thoracic, lumbar, and sacral spine, 98% of the screws were accurately placed (grade 0, 1, and juxta pedicular). A total of 56 screws (0.88%) breached more than 4 mm (grade 3), and 17 (0.26%) screws were replaced. No new and permanent neurological, vascular, or visceral complications were encountered.

conclusionsThe free-hand technique for pedicle screw placement in the acceptable and safety zone in pedicles and vertebral bodies was 98%. No complications associated with screw insertion in growth were noted. The free-hand technique for pedicle screw placement can be safely used in patients at any age. The screw accuracy does not depend on the child's age nor the size of the deformity curve. Segmental instrumentation with posterior fixation in children with spinal deformities can be performed with a very low complication rate. Navigation of the robot is only an auxiliary tool in the hands of the surgeons, and the result of the work ultimately depends on the surgeons.

Indexed as

pedicle screwscoliosisscrew accuracyscrew placementspinal deformity

Identifiers

PMID37373646
PMCPMC10299159
OpenAlexW4380083926

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Registered trials

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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.