Accuracy of pedicle screw fixation in lumbar spine by freehand technique studied postoperatively by computed tomography

Abstract

Background: Spinal stabilization using pedicle screw has been widely used in spinal surgery for the management of various pathologies. Aims: We aimed to assess the accuracy of pedicle screw fixation in the lumbar spine by freehand technique studied by postoperative computed tomography (CT) scan. Setting and Design: This prospective observational study was carried out in a tertiary healthcare facility specializing in managing spine deformities. Materials and Methods: The study involved 55 patients with 253 pedicle screws. The accuracy of pedicle screws is determined by calculating breaches in the cortex based on a postoperative CT scan done on three weeks’ postoperative follow-up (on suture removal) and confirming by the index surgeon. Postoperative CT was done in all the patients to evaluate implant position within the first month after surgery. Statistical Analysis: Chi-squared test was used to find the statistical significance. Results: In this study, the accuracy of the pedicle screw in the fixation of the lumbar spine was 95.25%, and the incidence of pedicle breaches was 4.75%. The left breach was comparatively higher than the right breach (5.51% vs. 3.96%). Among 12 breaches of the pedicle trajectory, 7 (58.33%) breaches as compared to the 5 (41.66%) on the left side (P = 0.99). Conclusion: In conclusion, CT scan is a reliable and effective method for postoperative assessment of spinal pedicle screw placement.