Abstract
In this study, a new percutaneous multi-function pedicle locator was designed for personalized three-dimensional positioning of a pedicle in minimally invasive spine surgery (MISS) without computer-assisted navigation technology. The proposed locator was used in a number of patients during MISS, and its advantages were analyzed. Based on the position of a pedicle determined by computed tomography (CT) and fluoroscopic images of a patient, 6 lines and 2 distances were used to determine the puncture point of a pedicle screw on skin, while 2 angles were used to indicate the direction of insertion of a pedicle guide needle from the patient's body surface. The results of the proposed locator were compared with those of the conventional freehand technique in MISS. The potential benefits of using the locator included enhanced surgical accuracy, reduced operation time, alleviation of the harmful intra-operative radiation exposure, lower costs, and shortened learning curve for young orthopedists.
Highlights
In this study, a new percutaneous multi-function pedicle locator was designed for personalized threedimensional positioning of a pedicle in minimally invasive spine surgery (MISS) without computerassisted navigation technology
MISS refers to any procedure that is less invasive than open surgery
Screws were originally placed via the conventional freehand technique and 2D fluoroscopy, increasing the risks of misplacement of screws and exposure to high levels of r adiation[6]
Summary
A new percutaneous multi-function pedicle locator was designed for personalized threedimensional positioning of a pedicle in minimally invasive spine surgery (MISS) without computerassisted navigation technology. The angle of the pedicle can change due to the extroversion angle of the pedicle, tilted head or tail, and even possible lateral curvature and rotation caused by serious degeneration, which may disturb the accuracy of pedicle screw placement This justifies why spinal surgery typically requires two-dimensional (2D) fluoroscopic imaging, and it is still not easy for the experienced orthopedic surgeons to ensure that screws can be placed accurately[4]. A simple and practical instrument has been designed for MISS It could greatly improve the accuracy of screw placement, create channels in pedicle, shorten significantly the operation time, and decrease harmful intra-operative radiation exposure, which reduced the cost of surgery. The percutaneous multifunction pedicle locator was clinically applied, and it achieved the predefined objectives
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