In vitro simulation. Early results of stereotaxy for pedicle screw placement |
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Authors: | AL Carl HS Khanuja BL Sachs CA Gatto J vomLehn K Vosburgh J Schenck W Lorensen K Rohling D Disler |
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Affiliation: | Division of Orthopaedic Surgery, Albany Medical College, New York, USA. |
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Abstract: | STUDY DESIGN: Frameless stereotaxy with doppler ultrasound and three dimensional computer model registration is assessed in vitro for pedicle screw placement. OBJECTIVE: To identify feasibility of pedicle screw navigation and placement using this technology. SUMMARY OF BACKGROUND DATA: Inaccurate pedicle screw placement can lead to neurovascular injury or suboptimal fixation. Present techniques in pedicle screw placement involve only confirmation of hole orientation. METHOD: Forty-four pedicle screws were placed in lumbosacral models and cadaver specimens. Accuracy was assessed with a computed tomography scan and vertebral cross sectioning. RESULTS: All screws were intrapedicular. Accuracy of anterior cortical fixation was 1.5 mm, with a range of 2.5 mm. CONCLUSION: In vitro frameless stereotaxy is accurate for pedicle screw placement. This technology adds a component of navigation to pedicle screw placement. |
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