Abstract
Accurately positioned pedicle screws offer optimal biomechanical fixation, making them a well-accepted treatment choice for a variety of spine pathologies [1,2]. However, up to 42% of pedicle screws were reported to be malpositioned
Highlights
Positioned pedicle screws offer optimal biomechanical fixation, making them a well-accepted treatment choice for a variety of spine pathologies [1,2]
With respect to screws considered as accurate placement on CT, twenty-four screws and one screw were rated as grade 1 and 2 respectively on cone-beam CT (CBCT) while they were rated grade 0 on CT, whereas thirteen screws and three screws were rated as grade 0 and 2 respectively on CBCT while they were rated as grade 1 on CT
With respect to screws considered as misplaced on CT, two screws were rated grade 0 and three screws were graded 1 on CBCT while they were rated as grade 2 on CT
Summary
Positioned pedicle screws offer optimal biomechanical fixation, making them a well-accepted treatment choice for a variety of spine pathologies [1,2]. In comparison to CT, radiography detects only 52% of misplaced screws [6,7], making intraoperative CT imaging necessary, especially for complex deformity, to avoid revision surgeries. Availability of intraoperative 3D imaging resulted in revision of 9% of screws intraoperatively, corresponding to 35% of the treated patients. Lower threshold for intraoperative revisions based on objective intraoperatively available imaging data, leads to fewer secondary revision surgeries [8]. Avoidance of postoperative revisions makes the initial investment in intraoperative 3D imaging technologies economically more attractive [9]. CBCT may be a viable and low radiation dose alternative, to provide intraoperative feedback to surgeons to permit in-room revisions of misplaced screws
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