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    Analysis of CT-based navigation system for pedicle screw placement

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    Authors
    Hodges, Scott D.
    Eck, Jason C.
    Newton, Danette
    UMass Chan Affiliations
    Department of Orthopedics and Physical Rehabilitation
    Document Type
    Journal Article
    Publication Date
    2012-08-01
    Keywords
    *Bone Screws
    Fluoroscopy
    Humans
    Intraoperative Period
    Lumbar Vertebrae
    Reoperation
    Retrospective Studies
    Spinal Fusion
    Stereotaxic Techniques
    *Surgery, Computer-Assisted
    Tomography, X-Ray Computed
    Orthopedics
    Rehabilitation and Therapy
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    Link to Full Text
    http://dx.doi.org/10.3928/01477447-20120725-23
    Abstract
    The incidence of pedicle screw breech varies based on anatomic location, body habitus, surgeon experience, spinal deformity, and surgical technique. Pedicle breeches have been reported to occur in up to 40% of screws. The purpose of this retrospective study was to compare the rates of revision of pedicle screw placement when using intraoperative C-arm vs O-arm (Medtronic, Memphis, Tennessee) assessment of pedicle screws. An economic analysis was also performed based on the estimated cost of pedicle screw revision. Four (1%) of 386 control patients required pedicle screw revision for a breeched pedicle screw not identified with intraoperative C-arm fluoroscopy. In the study group, none of the 331 patients returned to the operating room when O-arm was used to assess pedicle screw placement. Based on the 1% rate of returning to the operating room in the control group, the annual rate of cases nationwide requiring pedicle screw revision would be approximately 2300, with a cost of approximately $40,595,000.These results suggest that the use of intraoperative O-arm can reduce the need for revision of a breeched pedicle screw. This can potentially lead to a major cost savings.
    Source
    Orthopedics. 2012 Aug 1;35(8):e1221-4. doi: 10.3928/01477447-20120725-23. Link to article on publisher's site
    DOI
    10.3928/01477447-20120725-23
    Permanent Link to this Item
    http://hdl.handle.net/20.500.14038/42936
    PubMed ID
    22868609
    Related Resources
    Link to Article in PubMed
    ae974a485f413a2113503eed53cd6c53
    10.3928/01477447-20120725-23
    Scopus Count
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    UMass Chan Faculty and Researcher Publications
    Orthopedics and Physical Rehabilitation Publications

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