The researchers conducted an in vitro human cadaveric surgical technique study where surgeons placed screws using fluoroscopic guidance in a cadaveric model. Four surgeons—two residents, a fellow and an attending physician—performed the screw placement on 10 cadavers, for a total of 120 screws placed.
Here are five key notes:
1. In all, there were 35 screw violations; 26 violations occurred to the superior articular facet and five to the intra-articular facet joints. There were also four pedicular breaches.
2. There wasn’t a significant difference between the trainees in the likelihood to cause a violation.
3. There was a difference in the likelihood of violation between the trainees and the attending surgeon.
4. Factors such as the laterality, spinal level and patient BMI didn’t correlate with violation likelihood.
5. The study authors concluded, “Surgeons of differing training levels are able to safely and accurately place lumbar pedicle screws in a percutaneous manner, with a low likelihood of facet and pedicle wall violations.”
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