European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society
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Augmented reality (AR) is an emerging technology with great potential for surgical navigation through its ability to provide 3D holographic projection of otherwise hidden anatomical information. This pilot cadaver study investigated the feasibility and accuracy of one of the first holographic navigation techniques for lumbar pedicle screw placement. ⋯ This pilot study demonstrates improved angular precision in one of the first AR-navigated pedicle screw placement studies worldwide. Technical shortcomings need to be eliminated before potential clinical applications.
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Free-hand pedicle screw insertion methods are widely used for screw insertion during scoliosis surgery. Preoperative knowledge about the pedicle size helps to maximize screw containment and minimize the risk of pedicle breach. Radiographs taken by a biplanar low-dose X-ray device (EOS) have no divergence in the vertical plane. The criterion validity and reliability of preoperative EOS images for pedicle size measurements in patients with idiopathic scoliosis (IS) was investigated in this study. ⋯ The results of this study indicate a good validity and reliability for pedicle size measurements on EOS radiographs. Therefore, EOS radiographs may be used for a preoperative estimation of pedicle size and subsequent screw diameter in patients with IS.
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Navigation and robotic-guided systems are being used more often to facilitate efficient and accurate placement of hardware during spinal surgeries. Preoperative surgical planning is a key step in the safe use of these tools. No studies have yet investigated the predictive accuracy of surgical planning using a robotic guidance system. ⋯ This study indicates that the predictive accuracy of the use of preoperative planning software and robotic guidance to facilitate the surgical plan is within 6° and 9° in the coronal and sagittal planes, respectively.
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Vertebral body tethering (VBT) has been reported as a safe and effective non-fusion surgical technique for the treatment of adolescent idiopathic scoliosis, but the postoperative health of the bone and soft tissues of the spine following instrumentation remains unknown. We aimed to evaluate pathoanatomy and degenerative changes of the spine in adolescent idiopathic scoliosis patients both prior to and two years following VBT. ⋯ These preliminary data indicate that VBT may not result in significant degenerative changes in either the intervertebral discs or the posterior facets two years following instrumentation.
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To examine the clinical features and post-treatment complications in patients with isolated C2 odontoid fractures. ⋯ The great majority of isolated odontoid fractures occurred in elderly patients. Conservative treatment and surgery had similarly low in-hospital mortality. Use of halo-vest was not associated with an increase in mortality.