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Study: Intraoperative 3-D Imaging Can Improve Accuracy of Pedicle Screw Placement in Spine Surgery

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March 18, 2023
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Study: Intraoperative 3-D Imaging Can Improve Accuracy of Pedicle Screw Placement in Spine Surgery

LAS VEGAS, March 7, 2023 /PRNewswire/ — A examine 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 immediately on the American Academy of Orthopaedic Surgeons (AAOS) Annual Assembly in Las Vegas.  

Many spinal surgical procedures require using implants referred to as pedicle screws to stabilize the spine. Exact positioning of those screws is vital 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’s the potential {that a} two-dimensional picture alone won’t correctly exhibit the profitable placement of a screw,” stated Darren Lebl, MD, a spine surgeon at HSS and principal investigator of the examine. “As a substitute, three-dimensional intraoperative imaging methods at the moment are out there, providing improved visualization.”

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

Investigators analyzed information 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 have 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 medical analysis coordinator who offered the examine on the AAOS assembly. “False constructive findings are situations when BPR imaging suggests the screw was not in an appropriate place, whereas in reality a extra superior 3D picture (intraoperative 3D scan or postoperative CT scan) confirmed the screw to be in an appropriate place. Conversely, a false unfavourable occasion was when a BPR picture led one to imagine or appeared as if the screw was in an appropriate place, when in reality a extra superior 3D picture or post-operative CT scan confirmed that it was in reality not acceptable.”

Postoperative CT imaging revealed a clinically important 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.  

“Primarily based on our examine, BPR imaging could lead one to assume a screw is suitable when in reality it’s not, and in addition could miss many screws that aren’t in reality acceptable. In our examine, it was roughly one p.c of instances the place this occurred. Nonetheless, for surgeons and facilities that implant a whole bunch and hundreds of screws per 12 months, that is going to end in a major medical affect for many individuals,” Dr. Lebl famous. “Even one misplaced screw can have a major affect for a affected person, a surgeon, and a hospital system. Due to this fact, based mostly on these findings, we propose that for intraoperative affirmation of screw place 3D imaging could quickly characterize a brand new normal of care.”

Authors: Fedan Avrumova, BS; George Gorgy, MD; Philip Okay. Paschal, MS; John A. Carrino, MD, MPH; Darren R. Lebl, MD (HSS)

About HSS

HSS is the world’s main educational medical middle centered on musculoskeletal well being. At its core is Hospital for Particular Surgical procedure, nationally ranked No. 1 in orthopedics (for the thirteenth consecutive 12 months), No. 3 in rheumatology by U.S. Information & World Report (2022-2023), and the very best pediatric orthopedic hospital in NY, NJ and CT by U.S. Information & World Report “Greatest Kids’s Hospitals” listing (2022-2023). In a survey of medical professionals in additional than 20 international locations by Newsweek, HSS is ranked world #1 in orthopedics for a 3rd consecutive 12 months (2023). Based in 1863, the Hospital has the bottom complication and readmission charges within the nation for orthopedics, and among the many lowest an infection charges. HSS was the primary in New York State to obtain Magnet Recognition for Excellence in Nursing Service from the American Nurses Credentialing Middle 5 consecutive occasions. An affiliate of Weill Cornell Medical Faculty, HSS has a most important campus in New York Metropolis and services in New Jersey, Connecticut and within the Lengthy Island and Westchester County areas of New York State, in addition to in Florida. Along with affected person care, HSS leads the sector in analysis, innovation and training. The HSS Analysis Institute contains 20 laboratories and 300 workers members centered on main the development of musculoskeletal well being via prevention of degeneration, tissue restore and tissue regeneration. The HSS Innovation Institute works to understand the potential of latest medication, therapeutics and gadgets. The HSS Training Institute is a trusted chief in advancing musculoskeletal data and analysis for physicians, nurses, allied well being professionals, educational trainees, and customers in additional than 145 international locations. The establishment is collaborating with medical facilities and different organizations to advance the standard and worth of musculoskeletal care and to make world-class HSS care extra extensively accessible nationally and internationally. www.hss.edu.

SOURCE Hospital for Particular Surgical procedure

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