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Reliability and consequences of intraoperative 3D imaging to control positions of thoracic pedicle screws

  • Orthopaedic Surgery
  • Published:
Archives of Orthopaedic and Trauma Surgery Aims and scope Submit manuscript

Abstract

Introduction

The insertion of thoracic pedicle screws (T1–T10) is subject to a relevant rate of malplacement. The optimum implantation procedure is still a topic of controversial debate. Currently, a postoperative computed tomography is required to evaluate the screw positions. The present study was undertaken to clarify whether intraoperative 3D imaging is a reliable method of determining the position of thoracic pedicle screws.

Methods

This prospective study involved 40 consecutive patients with thoracic spinal injuries, with intraoperative 3D scans being performed to determine the positions of 240 pedicle screws in T1–T10. The results of the 3D scans were compared with the findings of postoperative CT scans, using a clinical classification system.

Results

The positions of 204 pedicle screws could be viewed by means of both 3D and CT scans and the results compared. The 3D scans achieved a sensitivity of 90.9 % and a specificity of 98.8 %. The rate of misclassification by the 3D scans was 2.5 %. Nine pedicle screws were classified as misplaced and their position corrected intraoperatively (3.8 %). No screws required postoperative revision.

Conclusions

Performing an intraoperative 3D scan enables the position of thoracic pedicle screws to be determined with sufficient accuracy. The rate of revision surgery was reduced to 0 %.

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Acknowledgments

The authors thank T. Wodetzki (University of Rostock) for designing the medical illustrations.

Conflict of interest

No funds were received in support of this work. No benefits in any form have been or will be received from a commercial party related directly or indirectly to the subject of the manuscript including National Institutes of Health (NIH), Wellcome Trust, Howard Hughes Medical Institute (HHMI), and others.

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Authors and Affiliations

  1. Department of Trauma and Orthopedic Surgery, St. Bernward Krankenhaus, Treibestrasse 9, 31139, Hildesheim, Germany

    Markus Beck

  2. Department of Trauma and Reconstructive Surgery, University of Rostock, Schillingallee 35, 18057, Rostock, Germany

    Robert Rotter, Georg Gradl, Philipp Herlyn, Thomas Mittlmeier & Philip Gierer

  3. Spinecenter, Klinik St. Anna, St. Anna-Strasse 32, 6006, Lucerne, Switzerland

    Markus Kröber

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  1. Markus Beck
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  2. Robert Rotter
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  3. Georg Gradl
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  4. Philipp Herlyn
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Correspondence to Markus Beck.

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Beck, M., Rotter, R., Gradl, G. et al. Reliability and consequences of intraoperative 3D imaging to control positions of thoracic pedicle screws. Arch Orthop Trauma Surg 132, 1371–1377 (2012). https://doi.org/10.1007/s00402-012-1555-y

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  • DOI: https://doi.org/10.1007/s00402-012-1555-y

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