Advantages and Disadvantages of Multi-axis Intraoperative Angiography Unit for Percutaneous Pedicle Screw Placement in the Lumbar Spine

Neurol Med Chir (Tokyo). 2017 Sep 15;57(9):481-488. doi: 10.2176/nmc.oa.2017-0059. Epub 2017 Aug 1.

Abstract

We analyzed clinical usefulness of the high resolution imaging system in a hybrid operation room (OR) for posterior lumbar interbody fusion. A total of 17 patients with lumbar spondylolisthesis between February 2014 and August 2016 were included. Multi-axis imaging system in a hybrid OR was used in 12 patients (hybrid OR group); the conventional C-arm fluoroscopy, in 5 patients (C-arm group). The time to confirm the first percutaneous pedicle screw (PPS) angle (hybrid OR, 80 vs C-arm, 249 s; P = 0.0026) and the second to the last PPS angle (77 vs 90 s; P = 0.040) were shorter in the hybrid OR group. Placement accuracy was higher in the hybrid OR group (88.0 vs 59.1%; P = 0.010). Irradiation dose was significantly lower in the C-arm group (462 vs 102 mGy; P = 0.0013). This study suggested that the accuracy of PPS placement and time to confirm the PPS angle are the advantages in a hybrid OR.

Keywords: fluoroscopy; hybrid operation room; lumbar spine; multi-axis angiography unit; percutaneous pedicle screw.

MeSH terms

  • Aged
  • Angiography*
  • Female
  • Fluoroscopy
  • Humans
  • Lumbar Vertebrae*
  • Male
  • Middle Aged
  • Pedicle Screws*
  • Retrospective Studies
  • Spinal Fusion*
  • Spondylolisthesis / diagnostic imaging
  • Spondylolisthesis / surgery*
  • Surgery, Computer-Assisted*
  • Treatment Outcome