Does the Full Power-Assisted Technique Used in Pedical Screw Placement Affect the Safety and Efficacy of Adolescent Idiopathic Scoliosis Surgery?

Abstract

The new full power-assisted (FPA) technique used in pedicle screw placement during adolescent idiopathic scoliosis (AIS) surgery streamlines the surgical procedure and reduces repetitive surgeon tasks. However, the use of the FPA technique may also negatively affect the surgical safety and efficacy of patients with AIS. The purpose of this study was to investigate the effect of the FPA technique on the accuracy of pedicle screw placement, as well as on operating time, blood loss, and clinical outcomes. A total of 105 patients with AIS with major thoracic curves treated with posterior instrumentation and fusion were randomized into 2 groups. With the new FPA technique, 427 pedicle screws were implanted in the thoracic region in 35 patients (the FPA group), and using the conventional freehand (FH) technique, 896 screws were implanted in 70 patients (the FH group). The primary end point screw position was assessed using postoperative computed tomography. Secondary end points, such as operative time, blood loss, and clinical outcomes, were also assessed. The FPA technique did not significantly affect the accuracy rate of the pedicle screw placement, scoliosis correction, total operating time, or total blood loss. However, the surgical times for the screw insertion phase and for each screw placement were significantly shorter for the FPA group compared with the FH group (P < 0.001). Compared with the conventional manual tools, use of the FPA technique seemed to be superior and had relatively shorter pedicle screw placement times, with comparable surgical safety and efficacy for patients with AIS.