A new study published in Clinical Spine Surgery examines pedicle screw placement with intraoperative CT and image-guided navigation for children under 10 years old.
The study authors examined 16 patients who underwent 17 surgeries at two institutions between 2007 and 2013. There were 130 pedicle screws placed and seven lateral mass screws placed in the patients using either the open technique with intraoperative CT and image-guided navigation. Congenital deformity was the most common diagnosis.
The researchers found:
1. Three of the 137 screws required revisions to shorter screws. The overall accuracy rate was 97.8 percent.
2. The right T3 screw was revised due to anterior penetration in one case; in another, the left-sided T1 and T2 pedicle screws were shortened 5 mm because they penetrated the anterior aspects of the vertebral bodies.
3. There weren’t any screw-related complications.
4. The surgeons using image-guided navigation reported screw placement accuracy in the patients with no associated intraoperative complications.
5. The 97.8 percent accuracy is significantly higher than the reported 90.9 percent accuracy without navigation in the same age group.
“Intraoperative CT and image guidance were useful in our practice for placement of screws in skeletally immature patients,” concluded the study authors.