Navigated guide tube for the placement of mini-open pedicle screws using stereotactic 3D navigation without the use of K-wires ; Technical note

Benjamin J. Shin, Innocent U. Njoku, A. John Tsiouris, Roger Härtl

Research output: Contribution to journalArticle

11 Citations (Scopus)

Abstract

Object. Three-dimensional spinal navigation increases screw accuracy, but its implementation in clinical practice has been difficult, mainly because of surgeons' concerns about increased operative times, disturbance of workflow, and safety. The authors present a custom-designed navigated guide that addresses some of these concerns by allowing for drilling, tapping, and placing the final screw via a minimally invasive approach without the need for K-wires. In this paper, the authors' goal was to describe the technical aspects of the navigated guide tube as well as pedicle screw accuracy. Methods. The authors present the technical details of a navigated guide that allows drilling, tapping, and the placement of the final screw without the need for K-wires. The first 10 patients who received minimally invasive mini-open spinal pedicle screws are presented. The case series focuses on the immediate postoperative outcomes, pedicle screw accuracy, and pedicle screw-related complications. An independent board-certified neuroradiologist determined pedicle screw accuracy according to a 4-tiered grading system. Results. The navigated guide allowed successful placement of mini-open pedicle screws as part of posterior fixation from L-1 to S-1 without the use of K-wires. Only 7-mm-diameter screws were placed, and 72% of screws were completely contained within the pedicle. Breaches less than 2 mm were seen in 23% of cases, and these were all lateral except for one screw. Breaches were related to the lateral to medial trajectory chosen to avoid the superior facet joint. There were no complications related to pedicle screw insertion. Conclusions. A novel customized navigated guide tube is presented that facilitates the workflow and allows accurate placement of mini-open pedicle screws without the need for K-wires.

Original languageEnglish (US)
Pages (from-to)178-183
Number of pages6
JournalJournal of Neurosurgery: Spine
Volume18
Issue number2
DOIs
StatePublished - Feb 1 2013

Fingerprint

Workflow
Zygapophyseal Joint
Pedicle Screws
Operative Time
Safety
Surgeons

All Science Journal Classification (ASJC) codes

  • Surgery
  • Neurology
  • Clinical Neurology

Cite this

@article{805e6549f24e46acbd2ab34c5a2bc902,
title = "Navigated guide tube for the placement of mini-open pedicle screws using stereotactic 3D navigation without the use of K-wires ; Technical note",
abstract = "Object. Three-dimensional spinal navigation increases screw accuracy, but its implementation in clinical practice has been difficult, mainly because of surgeons' concerns about increased operative times, disturbance of workflow, and safety. The authors present a custom-designed navigated guide that addresses some of these concerns by allowing for drilling, tapping, and placing the final screw via a minimally invasive approach without the need for K-wires. In this paper, the authors' goal was to describe the technical aspects of the navigated guide tube as well as pedicle screw accuracy. Methods. The authors present the technical details of a navigated guide that allows drilling, tapping, and the placement of the final screw without the need for K-wires. The first 10 patients who received minimally invasive mini-open spinal pedicle screws are presented. The case series focuses on the immediate postoperative outcomes, pedicle screw accuracy, and pedicle screw-related complications. An independent board-certified neuroradiologist determined pedicle screw accuracy according to a 4-tiered grading system. Results. The navigated guide allowed successful placement of mini-open pedicle screws as part of posterior fixation from L-1 to S-1 without the use of K-wires. Only 7-mm-diameter screws were placed, and 72{\%} of screws were completely contained within the pedicle. Breaches less than 2 mm were seen in 23{\%} of cases, and these were all lateral except for one screw. Breaches were related to the lateral to medial trajectory chosen to avoid the superior facet joint. There were no complications related to pedicle screw insertion. Conclusions. A novel customized navigated guide tube is presented that facilitates the workflow and allows accurate placement of mini-open pedicle screws without the need for K-wires.",
author = "Shin, {Benjamin J.} and Njoku, {Innocent U.} and Tsiouris, {A. John} and Roger H{\"a}rtl",
year = "2013",
month = "2",
day = "1",
doi = "10.3171/2012.10.SPINE12569",
language = "English (US)",
volume = "18",
pages = "178--183",
journal = "Journal of Neurosurgery: Spine",
issn = "1547-5654",
publisher = "American Association of Neurological Surgeons",
number = "2",

}

Navigated guide tube for the placement of mini-open pedicle screws using stereotactic 3D navigation without the use of K-wires ; Technical note. / Shin, Benjamin J.; Njoku, Innocent U.; Tsiouris, A. John; Härtl, Roger.

In: Journal of Neurosurgery: Spine, Vol. 18, No. 2, 01.02.2013, p. 178-183.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Navigated guide tube for the placement of mini-open pedicle screws using stereotactic 3D navigation without the use of K-wires ; Technical note

AU - Shin, Benjamin J.

AU - Njoku, Innocent U.

AU - Tsiouris, A. John

AU - Härtl, Roger

PY - 2013/2/1

Y1 - 2013/2/1

N2 - Object. Three-dimensional spinal navigation increases screw accuracy, but its implementation in clinical practice has been difficult, mainly because of surgeons' concerns about increased operative times, disturbance of workflow, and safety. The authors present a custom-designed navigated guide that addresses some of these concerns by allowing for drilling, tapping, and placing the final screw via a minimally invasive approach without the need for K-wires. In this paper, the authors' goal was to describe the technical aspects of the navigated guide tube as well as pedicle screw accuracy. Methods. The authors present the technical details of a navigated guide that allows drilling, tapping, and the placement of the final screw without the need for K-wires. The first 10 patients who received minimally invasive mini-open spinal pedicle screws are presented. The case series focuses on the immediate postoperative outcomes, pedicle screw accuracy, and pedicle screw-related complications. An independent board-certified neuroradiologist determined pedicle screw accuracy according to a 4-tiered grading system. Results. The navigated guide allowed successful placement of mini-open pedicle screws as part of posterior fixation from L-1 to S-1 without the use of K-wires. Only 7-mm-diameter screws were placed, and 72% of screws were completely contained within the pedicle. Breaches less than 2 mm were seen in 23% of cases, and these were all lateral except for one screw. Breaches were related to the lateral to medial trajectory chosen to avoid the superior facet joint. There were no complications related to pedicle screw insertion. Conclusions. A novel customized navigated guide tube is presented that facilitates the workflow and allows accurate placement of mini-open pedicle screws without the need for K-wires.

AB - Object. Three-dimensional spinal navigation increases screw accuracy, but its implementation in clinical practice has been difficult, mainly because of surgeons' concerns about increased operative times, disturbance of workflow, and safety. The authors present a custom-designed navigated guide that addresses some of these concerns by allowing for drilling, tapping, and placing the final screw via a minimally invasive approach without the need for K-wires. In this paper, the authors' goal was to describe the technical aspects of the navigated guide tube as well as pedicle screw accuracy. Methods. The authors present the technical details of a navigated guide that allows drilling, tapping, and the placement of the final screw without the need for K-wires. The first 10 patients who received minimally invasive mini-open spinal pedicle screws are presented. The case series focuses on the immediate postoperative outcomes, pedicle screw accuracy, and pedicle screw-related complications. An independent board-certified neuroradiologist determined pedicle screw accuracy according to a 4-tiered grading system. Results. The navigated guide allowed successful placement of mini-open pedicle screws as part of posterior fixation from L-1 to S-1 without the use of K-wires. Only 7-mm-diameter screws were placed, and 72% of screws were completely contained within the pedicle. Breaches less than 2 mm were seen in 23% of cases, and these were all lateral except for one screw. Breaches were related to the lateral to medial trajectory chosen to avoid the superior facet joint. There were no complications related to pedicle screw insertion. Conclusions. A novel customized navigated guide tube is presented that facilitates the workflow and allows accurate placement of mini-open pedicle screws without the need for K-wires.

UR - http://www.scopus.com/inward/record.url?scp=84873690374&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84873690374&partnerID=8YFLogxK

U2 - 10.3171/2012.10.SPINE12569

DO - 10.3171/2012.10.SPINE12569

M3 - Article

C2 - 23198696

AN - SCOPUS:84873690374

VL - 18

SP - 178

EP - 183

JO - Journal of Neurosurgery: Spine

JF - Journal of Neurosurgery: Spine

SN - 1547-5654

IS - 2

ER -