Increased Radiation but No Benefits in Pedicle Screw Accuracy With Navigation versus a Freehand Technique in Scoliosis Surgery.

Increased Radiation but No Benefits in Pedicle Screw Accuracy With Navigation versus a Freehand Technique in Scoliosis Surgery. Clin Orthop Relat Res. 2018 Feb 08;: Authors: Urbanski W, Jurasz W, Wolanczyk M, Kulej M, Morasiewicz P, Dragan SL, Zaluski R, Miekisiak G, Dragan SF Abstract BACKGROUND: The clinical value of pedicle screws in spinal deformity surgery is well known; however, screw insertion is demanding and sometimes associated with complications. Navigation systems based on intraoperatively obtained three-dimensional (3-D) images were developed to minimize pedicle screw misplacements. However, there is a lack of data confirming superiority of navigation above other techniques. There are also concerns regarding increased radiation used during the procedure. QUESTIONS/PURPOSES: The purposes of this study were (1) to compare accuracy of the two methods of pedicle screws placement: intraoperative 3-D image navigation versus a freehand technique in patients with idiopathic scoliosis; and (2) to assess the radiation dose received by patients with both methods. METHODS: Between 2014 and 2016, 49 patients underwent posterior spinal fusion with all pedicle screw constructs for idiopathic scoliosis performed by two surgeons. The study design involved alternating the use of the freehand technique and navigation to position pedicle screws in consecutive patients, forming groups of 27 patients with 451 navigated screws and 22 patients with 384 sc...
Source: Clinical Orthopaedics and Related Research - Category: Orthopaedics Authors: Tags: Clin Orthop Relat Res Source Type: research

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ABSTRACTFibrous dysplasia (FD) is a mosaic skeletal disorder resulting in fractures, deformity, and functional impairment. Clinical evaluation has been limited by a lack of surrogate endpoints capable of quantitating disease activity. The purpose of this study was to investigate the utility of18F ‐NaF PET/CT imaging in quantifying disease activity in patients with FD. Fifteen consecutively evaluated subjects underwent whole‐body18F ‐NaF PET/CT scans, and FD burden was assessed by quantifying FD‐related18F ‐NaF activity.18F ‐NaF PET/CT parameters obtained included (i) SUVmax (standardized uptake value [SUV] of t...
Source: Journal of Bone and Mineral Research - Category: Orthopaedics Authors: Tags: Original Article Source Type: research
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Source: Journal of Pediatric Orthopaedics - Category: Orthopaedics Tags: Selected Topics Source Type: research
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Source: European Spine Journal - Category: Orthopaedics Source Type: research
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Source: Neurocirugia - Category: Neurosurgery Authors: Tags: Neurocirugia (Astur) Source Type: research
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Source: Spine - Category: Orthopaedics Tags: DEFORMITY Source Type: research
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Source: Spine Deformity - Category: Orthopaedics Source Type: research
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Source: Journal of Bone and Mineral Research - Category: Orthopaedics Authors: Tags: Original Article Source Type: research
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Source: Journal of Nuclear Medicine - Category: Nuclear Medicine Authors: Tags: Musculoskeletal Posters Source Type: research
Conclusion. The larger the scoliotic curve, the aorta was located further away from the apical vertebral wall. The aorta has less risk of injury from the left lateral pedicle screw breach in larger scoliotic curve at the apical region. The distance from the pedicle screw entry point to the wall of the aorta was generally small (less than 30 mm) in the thoracic region (T4–T10). Level of Evidence: 4
Source: Spine - Category: Orthopaedics Tags: DEFORMITY Source Type: research
Conclusion. A pedicle screw insertion at the T3 or T4 vertebra on the concave side is not always possible in cases of a structural proximal thoracic curve; however, the pedicle width of the T2 vertebra is very wide and safe for the standard pedicle screw insertion. These results should be considered when the surgeon decides the upper instrumented vertebra or the correction method for the structural proximal thoracic curve. Level of Evidence: 3
Source: Spine - Category: Orthopaedics Tags: DEFORMITY Source Type: research
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