Comparison of pedicle screw placement accuracy between two types of imaging support (Artis Zeego versus two-dimensional fluoroscopy): a cross-sectional observational study
Abstract Background The pedicle screw system is widely used in spine surgery, and it provides rigid fixation and leads to successful subsequent deformity correction and bony fusion. The standard imaging technique for pedicle screw insertion is two-dimensional images obtained from C-arm-type X-ray fl...
| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
BMC
2022-07-01
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| Series: | BMC Musculoskeletal Disorders |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12891-022-05602-4 |
| _version_ | 1811219035851849728 |
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| author | Akira Matsuoka Tomoaki Toyone Ichiro Okano Yoshifumi Kudo Koji Ishikawa Hiroshi Maruyama Tomoyuki Ozawa Toshiyuki Shirahata Katsunori Inagaki |
| author_facet | Akira Matsuoka Tomoaki Toyone Ichiro Okano Yoshifumi Kudo Koji Ishikawa Hiroshi Maruyama Tomoyuki Ozawa Toshiyuki Shirahata Katsunori Inagaki |
| author_sort | Akira Matsuoka |
| collection | DOAJ |
| description | Abstract Background The pedicle screw system is widely used in spine surgery, and it provides rigid fixation and leads to successful subsequent deformity correction and bony fusion. The standard imaging technique for pedicle screw insertion is two-dimensional images obtained from C-arm-type X-ray fluoroscopy. Artis Zeego is an emerging intraoperative imaging technique that can provide conventional two-dimensional fluoroscopic images and rapid three-dimensional fluoroscopic computed tomography reconstruction imaging. The aim of this study is to compare the insertion accuracies of PS placement using Artis Zeego and conventional 2D X-ray fluoroscopy. Methods In this study, we retrospectively reviewed the postoperative images of thoracolumbar fusion patients who underwent surgery using pedicle screws between 2013 and 2018. Pedicle screw malplacement was assessed using a four-grade classification by Rao et al. Misplacement rates were compared between pedicle screws assisted with Artis Zeego and two-dimensional fluoroscopy. Results A total of 1107 pedicle screws in 153 patients were inserted using Artis Zeego, and 427 pedicle screws in 80 patients were inserted using fluoroscopy. The overall perforation rate was 4.2% (46 perforations of 1106 pedicle screws) in the Artis Zeego group and 7.7% (33 perforations of 427 pedicle screws) in the fluoroscopy group. In the Artis Zeego group, 43 (3.9%) screws were classified as grade 1, and three (0.3%) screws were classified as grade 2. In the fluoroscopy group, 21 (4.9%) screws were classified as grade 1, 10 (2.3%) screws were classified as grade 2, and 2 (0.5%) screws were classified as grade 3. The use of Artis Zeego was associated with a significantly lower screw malplacement rate than was the use of fluoroscopy (p < 0.001). Conclusions Our results demonstrated that pedicle screw placement with Artis Zeego was associated with a lower malplacement rate than was conventional two-dimensional fluoroscopy. No severe malplacement was observed in the Artis Zeego group. Thus, Artis Zeego could be a good option for improving pedicle screw accuracy. |
| first_indexed | 2024-04-12T07:18:59Z |
| format | Article |
| id | doaj.art-0ac9791992084a619694924669010419 |
| institution | Directory Open Access Journal |
| issn | 1471-2474 |
| language | English |
| last_indexed | 2024-04-12T07:18:59Z |
| publishDate | 2022-07-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Musculoskeletal Disorders |
| spelling | doaj.art-0ac9791992084a6196949246690104192022-12-22T03:42:22ZengBMCBMC Musculoskeletal Disorders1471-24742022-07-012311810.1186/s12891-022-05602-4Comparison of pedicle screw placement accuracy between two types of imaging support (Artis Zeego versus two-dimensional fluoroscopy): a cross-sectional observational studyAkira Matsuoka0Tomoaki Toyone1Ichiro Okano2Yoshifumi Kudo3Koji Ishikawa4Hiroshi Maruyama5Tomoyuki Ozawa6Toshiyuki Shirahata7Katsunori Inagaki8Department of Orthopaedic Surgery, Showa University School of MedicineDepartment of Orthopaedic Surgery, Showa University School of MedicineDepartment of Orthopaedic Surgery, Showa University School of MedicineDepartment of Orthopaedic Surgery, Showa University School of MedicineDepartment of Orthopaedic Surgery, Showa University School of MedicineDepartment of Orthopaedic Surgery, Showa University School of MedicineDepartment of Orthopaedic Surgery, Showa University School of MedicineDepartment of Orthopaedic Surgery, Showa University School of MedicineDepartment of Orthopaedic Surgery, Showa University School of MedicineAbstract Background The pedicle screw system is widely used in spine surgery, and it provides rigid fixation and leads to successful subsequent deformity correction and bony fusion. The standard imaging technique for pedicle screw insertion is two-dimensional images obtained from C-arm-type X-ray fluoroscopy. Artis Zeego is an emerging intraoperative imaging technique that can provide conventional two-dimensional fluoroscopic images and rapid three-dimensional fluoroscopic computed tomography reconstruction imaging. The aim of this study is to compare the insertion accuracies of PS placement using Artis Zeego and conventional 2D X-ray fluoroscopy. Methods In this study, we retrospectively reviewed the postoperative images of thoracolumbar fusion patients who underwent surgery using pedicle screws between 2013 and 2018. Pedicle screw malplacement was assessed using a four-grade classification by Rao et al. Misplacement rates were compared between pedicle screws assisted with Artis Zeego and two-dimensional fluoroscopy. Results A total of 1107 pedicle screws in 153 patients were inserted using Artis Zeego, and 427 pedicle screws in 80 patients were inserted using fluoroscopy. The overall perforation rate was 4.2% (46 perforations of 1106 pedicle screws) in the Artis Zeego group and 7.7% (33 perforations of 427 pedicle screws) in the fluoroscopy group. In the Artis Zeego group, 43 (3.9%) screws were classified as grade 1, and three (0.3%) screws were classified as grade 2. In the fluoroscopy group, 21 (4.9%) screws were classified as grade 1, 10 (2.3%) screws were classified as grade 2, and 2 (0.5%) screws were classified as grade 3. The use of Artis Zeego was associated with a significantly lower screw malplacement rate than was the use of fluoroscopy (p < 0.001). Conclusions Our results demonstrated that pedicle screw placement with Artis Zeego was associated with a lower malplacement rate than was conventional two-dimensional fluoroscopy. No severe malplacement was observed in the Artis Zeego group. Thus, Artis Zeego could be a good option for improving pedicle screw accuracy.https://doi.org/10.1186/s12891-022-05602-4Spine surgeryPedicle screw system2D X-ray fluoroscopyArtis ZeegoCone-beam computed tomography |
| spellingShingle | Akira Matsuoka Tomoaki Toyone Ichiro Okano Yoshifumi Kudo Koji Ishikawa Hiroshi Maruyama Tomoyuki Ozawa Toshiyuki Shirahata Katsunori Inagaki Comparison of pedicle screw placement accuracy between two types of imaging support (Artis Zeego versus two-dimensional fluoroscopy): a cross-sectional observational study BMC Musculoskeletal Disorders Spine surgery Pedicle screw system 2D X-ray fluoroscopy Artis Zeego Cone-beam computed tomography |
| title | Comparison of pedicle screw placement accuracy between two types of imaging support (Artis Zeego versus two-dimensional fluoroscopy): a cross-sectional observational study |
| title_full | Comparison of pedicle screw placement accuracy between two types of imaging support (Artis Zeego versus two-dimensional fluoroscopy): a cross-sectional observational study |
| title_fullStr | Comparison of pedicle screw placement accuracy between two types of imaging support (Artis Zeego versus two-dimensional fluoroscopy): a cross-sectional observational study |
| title_full_unstemmed | Comparison of pedicle screw placement accuracy between two types of imaging support (Artis Zeego versus two-dimensional fluoroscopy): a cross-sectional observational study |
| title_short | Comparison of pedicle screw placement accuracy between two types of imaging support (Artis Zeego versus two-dimensional fluoroscopy): a cross-sectional observational study |
| title_sort | comparison of pedicle screw placement accuracy between two types of imaging support artis zeego versus two dimensional fluoroscopy a cross sectional observational study |
| topic | Spine surgery Pedicle screw system 2D X-ray fluoroscopy Artis Zeego Cone-beam computed tomography |
| url | https://doi.org/10.1186/s12891-022-05602-4 |
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