Pedicle screw placement: Does intraoperative CT make a difference? — 5 findings

Spine

Spine surgeon researchers examined the safety and efficacy of pedicle screw placement using intraoperative CT and published their results in the Journal of Neurosurgery: Spine.

In one of the first studies describing North American experiences with intraoperative CT scanning to confirm pedicle screw placement, researchers examined cases December 2009 to July 2012. There were 203 patients included in the study and 1,148 screws. The researchers found:

 

•    8.9 percent of the screws were revised intraoperatively.
•    72 patients — or 35.5 percent — underwent intraoperative revisions.
•    18.4 percent of the revised screws were in the cervical spine.
•    7.5 percent of the revised screws were in the thoracic spine.
•    8.8 percent of the revised screws were in the lumbar spine.

 

There were also two patients who required reoperation due to undetected misplaced pedicle screws. The researchers also found intraoperative CT lowered the threshold for pedicle screw revision, so there was a statistically higher rate of screw revision in the thoracic and lumbar spine.

 

The authors did not find a rate reduction in reoperation or misplaced screws during the study period.

 

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