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Comparative Results Between Conventional and Computer-Assisted Pedicle Screw Installation in the Thoracic, Lumbar, and Sacral Spine
Abstract
STUDY DESIGN: A comparative study on the position of pedicle screws in patients treated surgically with and without computer assistance. OBJECTIVES: To evaluate the accuracy of computer-assisted pedicle screw installation, and to evaluate its clinical benefit as compared with conventional pedicle screw installation techniques. SUMMARY OF BACKGROUND DATA: In vitro and clinical studies have documented a significant rate of misplaced screws in the thoracolumbar area. Neurologic complications are recognized problems caused by screw misplacement. METHODS: Patients treated surgically with computer assistance were compared with a historical control group of patients treated surgically with conventional techniques in the same hospital and by the same surgical team. All screw positions were measured with a postoperative magnetic resonance tomography, and cortical effractions were categorized in 2-mm increments. Patients' charts also were reviewed to assess individual neurologic outcomes. RESULTS: The control cohort was composed of 100 patients, with 544 screws from T5 to S1. The computer-assisted cohort was composed of 50 patients, with 294 screws from T2 to S1. In the control cohort, 461 of 544 screws (85%) were found completely within their pedicles as compared with 278 of 294 screws (95%) correctly placed in the computer-assisted group (P < 0.0001). All 16 screws incorrectly placed with computer assistance were found 0.1 mm to 2 mm from the pedicle cortex. In the control cohort, 68 screws were found 0.1 mm to 2 mm, 10 screws 2.1 mm to 4 mm, and 5 screws more than 4 mm from the pedicle cortex. Seven patients in the control cohort were surgically retreated because of postoperative neurologic deficits, whereas no patients in the computer-assisted group were surgically retreated. CONCLUSIONS: Computer assistance can decrease the incidence of incorrectly positioned pedicle screws.
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Cited by
Accuracy of augmented reality-assisted pedicle screw placement: A systematic review
Youssef, S., McDonnell, J. M., Wilson, K. V., Turley, L., Cunniffe, G., Morris, S., Darwish, S., & Butler, J. S. (2024) · European Spine Journal · doi:10.1007/s00586-023-08094-5 · Cited by 36
“…accuracy between freehand and computer-aided placement using augmented reality, Amiot et al. found that in screws placed between T5 and S1, freehand placement had an error rate of 15.3% from 544 cases, whereas there was a 5.4% error rate from 294 cases when computer-assistance was used [42].”
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Metadata
- Authors
- Amiot, L.-P., Lang, K., Putzier, M., Zippel, H., & Labelle, H.
- Venue
- Spine
- Published
- 2000-03
- Volume
- 25
- Issue
- 5
- Pages
- 606-614
- ISSN
- 0362-2436 (ISSN-L)
- OpenAlex
- W2063177025
- Cited by
- 450
- References
- 0
- FWCI
- 18.09
- Type
- journal article
- Language
- en
- Open access
- closed
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