Intraoperative 3D imaging more effective in confirming the accuracy of pedicle screw placement during spine surgery

A research at Hospital for Particular Surgical procedure (HSS) discovered that intraoperative three-dimensional (3D) imaging was superior to two-dimensional radiographs in confirming the accuracy of pedicle screw placement throughout spine surgical procedure. The analysis was offered right now on the American Academy of Orthopaedic Surgeons (AAOS) Annual Assembly in Las Vegas.

Many spinal surgical procedures require the usage of implants known as pedicle screws to stabilize the spine. Exact positioning of those screws is essential for a profitable final result.

Two-dimensional biplanar radiographs [BPR] have been the gold normal to verify pedicle screw placement in spine fusion surgical procedure for a few years. Nonetheless, when using BPR, there may be the potential {that a} two-dimensional picture alone won’t correctly show the profitable placement of a screw. As a substitute, three-dimensional intraoperative imaging techniques at the moment are obtainable, providing improved visualization.”

Darren Lebl, MD, spine surgeon at HSS and principal investigator of the research

Dr. Lebl and colleagues got down to examine the accuracy of BPR versus 3D imaging when assessing intraoperative pedicle screw placement. “Our research is the primary to match the variations in intraoperative biplanar radiography and 3D imaging for pedicle screw accuracy in thoracic and lumbar circumstances utilizing robotic know-how,” Dr. Lebl famous.

Investigators analyzed knowledge from 103 sufferers who underwent spinal fusion by a single surgeon from 2019 to 2022. Pedicle screw placement was assessed with each intraoperative BPR and 3D imaging in every case.

“CT scans taken after surgical procedure had been in comparison with the findings of intraoperative BPR and 3D imaging to detect both false-positive or false-negative readings,” defined Fedan Avrumova, BS, an HSS scientific analysis coordinator who offered the research on the AAOS assembly. “False optimistic findings are cases when BPR imaging suggests the screw was not in an appropriate place, whereas in truth a extra superior 3D picture (intraoperative 3D scan or postoperative CT scan) confirmed the screw to be in an appropriate place. Conversely, a false unfavorable occasion was when a BPR picture led one to imagine or regarded as if the screw was in an appropriate place, when in truth a extra superior 3D picture or post-operative CT scan confirmed that it was in truth not acceptable.”

Postoperative CT imaging revealed a clinically vital variety of sufferers who had false-negative and false-positive screw placement readings on BPR. Nonetheless, screw place proven on intraoperative 3D imaging was discovered to be far more correct, Avrumova added.