CT guidance vs. free-hand scoliosis posterior spine surgery: 5 findings

Spine

A new study published in The Spine Journal compares image guidance with free-hand methods for placing pedicle screws during adolescent idiopathic scoliosis posterior spine surgery.

 

The study authors examined the Medline, Embase, CINAHL, Central and Web Science databases for studies with Level III or greater evidence. There were 79 patients included in the study. Here are five things to know:

 

1. The study breakdown includes:

 

• Comparison of CT guidance with freehand methods head-to-head: 4
• Image guidance: 8
• Free-hand methods: 67

 

2. In the head-to-head comparisons, there was moderate evidence of lower breach rates with CT-guidance than the free-hand methods.

 

3. There weren't any complications cited in the head-to-head studies.

 

4. Evidence in the cohort studies suggests CT guidance has lower point estimates of breach rates when compared with the free-hand method studies: 7.9 percent in the CT guidance studies versus 9.7 percent to 17.1 percent in the free-hand group.

 

5. The complication screw-related complication rates were 0 percent in the low-quality studies and 0 percent to 1.7 percent in the moderate quality studies.

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