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Use of computed tomographic reconstruction to establish the ideal entry point for pedicle screws in idiopathic scoliosis

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Abstract

Objective

To determine the ideal entry point for individual pedicle screw in the surgical treatment of idiopathic scoliosis using computed tomographic (CT) three-dimensional (3D) reconstruction.

Methods

Twenty patients with moderate or severe idiopathic scoliosis from two groups received surgical treatment using “Free Hand technique” and “Assisted Free Hand technique”. Computed tomographic scanning with 3D reconstruction of the thoracic and lumbar spine was conducted to determine the entry point and to evaluate the placement accuracy.

Results

The accuracy of placement was 88.2% in convexity and 84.5% in concavity for the “Free Hand” group, and 94.1% in convexity and 94% in concavity for the “Assisted Free Hand” group. Evidence showed that “Assisted Free Hand” group had higher accuracy when screws were placed in the thoracic spine (P = 0.02), while no obvious difference was seen in the lumbar spine placement (P = 0.47).

Conclusions

We conclude that in the surgical treatment of severe scoliosis, individual screw placement guided by entry points determined by CT reconstruction can result in improved accuracy and ease of the procedure.

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Abbreviations

CT:

Computed tomography

3D:

Three dimensional

VR:

Volume rendering

MPR:

Multi-planar reformation

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Acknowledgments

This research has received funding from The National Natural Science Foundation of China (Grant No. 30700456), Natural Science Foundation of Guangdong Province (Grant No. 8151008901000141) and Fundamental Research funds for the Central Universities (Grant No. 09 ykpy 30). One or more of the authors (DH, PS) have received funding from grants provided by Research Fund of National Natural Science Funds of China (30700456) and Yat-Sen Scholarship for Young Scientist. Foundation funds were received in support of this work. We wish to thank Heran Deng who served as the radiologist in this study.

Conflict of interest

We declare that we have no financial and personal relationships with other people or organizations that can inappropriately influence our work. There is no professional or other personal interest of any nature or kind in any product, service and/or company that could be construed as influencing the position presented in, or the review of the manuscript entitled.

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Authors and Affiliations

  1. Department of Orthopedics, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China

    Peiqiang Su

  2. Department of Orthopedics, Xiamen Traditional Chinese Medical Hospital, Xiamen, China

    Wentong Zhang

  3. Department of Orthopedics, The Second Affiliated Hospital of Sun Yat-Sen University, 107 West Yan Jiang Road, Guangzhou, PO Box 510120, China

    Yan Peng, Anjing Liang, Kaili Du & Dongsheng Huang

Authors
  1. Peiqiang Su
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  2. Wentong Zhang
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  3. Yan Peng
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  4. Anjing Liang
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  5. Kaili Du
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  6. Dongsheng Huang
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Corresponding author

Correspondence to Dongsheng Huang.

Additional information

P. Su and W. Zhang contributed equally to this work.

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Su, P., Zhang, W., Peng, Y. et al. Use of computed tomographic reconstruction to establish the ideal entry point for pedicle screws in idiopathic scoliosis. Eur Spine J 21, 23–30 (2012). https://doi.org/10.1007/s00586-011-1962-8

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  • DOI: https://doi.org/10.1007/s00586-011-1962-8

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