Fixation Technique with Pedicle Screws Assisted with Intraoperative TC and Neuronavigation: A Systematic Review

Author Info

Alejandra Arévalo-Sáenz Fernando J. Rascón-Ramírez Manuel Pedrosa Sánchez

Corresponding Author

Alejandra Arévalo-Sáenz
Department of Neurosurgery, Hospital Clinic San Carlos, Madrid, Spain

A B S T R A C T

Background: The invasion of the spinal canal or vertebral foramina by implants can cause lesions in neurovascular structures, which is why various methods have been tried to improve the accuracy of their placement during surgery. Objective: The objective´s review is to demonstrate, in our experience, the benefits of neuronavigation with intraoperative CT in spine surgery. Methods and Materials: We present a retrospective review of 307 posterior transpedicular fixations (1524 screws) made from January 2009 to December 2015. The following variables are collected: patient demographics, instrumented levels, type of operation, time of surgery as well as postoperative image control. Results: The average age has been 64.8 years; with discreet feminine predominance (57.3%). The predominant indication has been segmental instability, lumbar canal stenosis and spondylolisthesis. Levels L4-L5 and L5-S1 have been the most frequent. The predominant number of levels set by surgery has been 1 space (65%) and 2 spaces (22.7%). The study includes 11 different neurosurgeons. The rate of repositioning prior to hospital discharge was 0.2% (3/1524), a year of 0.32% (5/1524), and postoperative images were obtained by CT or MRI, which confirmed the correct placement of the implants, 1% of patients. Conclusion: Nowadays, the techniques of navigation and intraoperative images provide us with technical precision, reduction of surgical times and reduction of the radiation dose, among other advantages. In our experience, although anatomical knowledge is irreplaceable, these systems confer quality on spine surgery.

Article Info

Article Type

Review Article

Publication history

Received: Wed 25, Oct 2023
Accepted: Fri 17, Nov 2023
Published: Wed 06, Dec 2023

Copyright

© 2023 Alejandra Arévalo-Sáenz. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Hosting by Science Repository.
DOI: 10.31487/j.SCR.2023.06.02