title: Reduction in radiation during percutaneous lumbar pedicle screw placement using a new device.
abstract: OBJECTIVE
  To assess a new intradermal locator device for percutaneous placement of lumbar pedicle screws.
  
  
  METHODS
  Patients were alternately assigned to two groups. The locator group underwent lumbar pedicle screw placement using the intradermal locator. The control group was aided by traditional fluoroscopy. Baseline demographics, visual analog scale (VAS) pain scores, operation time, intraoperative fluoroscopy time and guidewire insertion time were recorded. All postoperative CT scans were reviewed by an independent spine surgeon to grade screw placement accuracy.
  
  
  RESULTS
  Thirty-six patients (180 screws) were assigned to the locator group and 30 patients (128 screws) to the control group. The locator device could significantly reduce the fluoroscopy time [3.9 sec (SD = 1.9) vs. 9.6 sec (SD = 5.8), p < 0.001] and guidewire insertion time [2.69 min (SD = 0.67) vs. 4.49 min (SD = 1.96), p < 0.001] compared with the conventional method for each pedicle screw. The whole operation time of the locator group was shorter than that of the control group [2-segment: 243.2 min (SD = 16.9) vs. 301.7 min (SD = 14.9), p < 0.001; 1-segment: 154.5 min (SD = 14.3) vs. 194.6 min (SD = 19.3), p < 0.001]. As for the rates of pedicle breaches, postoperative VAS scores, no significant difference was found between the two groups.
  
  
  CONCLUSIONS
  The intradermal locator device could help reduce the radiation exposure in percutaneous pedicle screw placement while maintaining the accuracy.
authors.affiliation: Department of Orthopaedics, The Tenth People's Hospital, Tongji University , Shanghai , China.
authors.forename: Lei
authors.initials: L
authors.lastname: Zhang
authors.forename: Xu
authors.initials: X
authors.lastname: Zhou
authors.forename: Xiaobing
authors.initials: X
authors.lastname: Cai
authors.forename: Hailong
authors.initials: H
authors.lastname: Zhang
authors.forename: Qingsong
authors.initials: Q
authors.lastname: Fu
authors.forename: Shisheng
authors.initials: S
authors.lastname: He
mesh_terms: D000328:Adult; D000368:Aged; D004867:Equipment Design; D005260:Female; D005471:Fluoroscopy / Q000379:methods*; D006801:Humans; D008159:Lumbar Vertebrae; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000295:instrumentation / Q000379:methods*; D061646:Operative Time; D010147:Pain Measurement; D010149:Postoperative Pain / Q000453:epidemiology; D065289:Pedicle Screws; D011446:Prospective Studies; D013122:Spinal Diseases / Q000601:surgery*; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D055815:Young Adult
keywords: Percutaneous pedicle screw; new device; radiation reduction; safe placement