Percutaneous Pedicle Screw Placement in the Lumbar Spine: A Comparison Study Between the Novel Guidance System and the Conventional Fluoroscopy Method.
METHODS
The clinical study was conducted on 145 patients who received either a novel guidance method or a conventional fluoroscopic method for the percutaneous pedicle screw placement in the lumbar spine.


OBJECTIVE
The aim of this study was to introduce a novel guidance method for percutaneous pedicle screw placement and to compare it with the conventional fluoroscopic method.


BACKGROUND
Conventional fluoroscopic method was associated with a long screw placement and a more fluoroscopy time. The novel guidance system effectively minimized the insertion and the radiation exposure times.


METHODS
A total of 145 patients were divided into 2 groups. A total of 65 patients (group A) underwent 152 percutaneous pedicle screw fixation by conventional fluoroscopic method. A total of 80 patients (group B) underwent 185 percutaneous pedicle screw fixation by a novel guidance method. Age, body mass index, and sex ratio were comparable between the 2 groups (P>0.05). The time of insertion, radiation exposure, and accuracy of the screw placement between the 2 groups were compared.


RESULTS
The mean time for a single pedicle screw placement was found to be 15.11±3.32 minutes in group A and 10.35±2.82 minutes in group B, respectively. The average radiation exposure was 9.06±2.15 s in group B and 13.07±3.06 s in group A, respectively. The differences were statistically significant for both screw placement and radiation exposure times (P<0.05). A total of 131 screws (86.2%) in group A and 163 screws (88.1%) in group B were perfectly located within the pedicle. The statistical difference was not significant (χ=0.277, P=0.598).


CONCLUSIONS
The novel guidance system significantly reduced the insertion time and radiation exposure, provided the screw placement was accurately performed when compared with the conventional method.
Department of Orthopedics, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, People's Republic of China.
Guangfei
G
Gu
Hailong
H
Zhang
Shisheng
S
He
Xiaobing
X
Cai
Xin
X
Gu
Jianbo
J
Jia
Qingsong
Q
Fu
Xu
X
Zhou
D005471:Fluoroscopy / Q000379:methods*; D006801:Humans; D008159:Lumbar Vertebrae / Q000601:surgery*; D065289:Pedicle Screws; D011300:Preoperative Care; D013123:Spinal Fusion