Pedicle Screw Instrumentation in Scoliosis Surgery: On Site Simulation Data on Accuracy and Efficiency With Different Techniques

• Published in: Spine (Philadelphia, Pa. 1976) Pa. 1976), 2020-06, Vol.45 (11), p.E670-E676
• Main Authors: Peiro-Garcia, Alejandro, Teles, Alisson R., Ojaghi, Reza, Ferri-de-Barros, Fábio
• Format: Article
• Language: English
• Subjects: Clinical Competence - standards; Data Analysis; Female; Humans; Male; Pedicle Screws; Prospective Studies; Scoliosis - diagnostic imaging; Scoliosis - surgery; Spinal Fusion - education; Spinal Fusion - instrumentation; Surgery, Computer-Assisted - education; Surgery, Computer-Assisted - instrumentation; Treatment Outcome
• ISSN: 0362-2436; 1528-1159
• DOI: 10.1097/BRS.0000000000003358

STUDY DESIGN.Prospective experimental study with on-site simulation. OBJECTIVE.To compare the accuracy and efficiency of different techniques for pedicle screw instrumentation (PSI). SUMMARY OF BACKGROUND DATA.Improving the safety and efficiency of PSI is a critical step to reduce the complication rates and the cost of scoliosis surgery. Innovative operative techniques for PSI have shown to safely improve efficiency, thereby reducing cost. Surgical simulation is a valuable tool to study different operative techniques. METHODS.Five spine fellows instrumented 20 simulation models of a scoliotic spine with 10 pedicle screws per model. Four techniques were studied, including the conventional pedicle probe and the innovative sequential drilling technique, with or without computed tomography (CT)-based navigation. Our primary outcome measures were efficiency and accuracy of PSI. We analyzed the data with bivariate analyses using the Chi-square test for categorical variables and the Student t test or ANalysis Of VAriance with Bonferroni post-hoc tests for continuous variables. RESULTS.The drilling techniques (free hand and navigated) were more efficient as compared with the pedicle probe techniques (P