Supraspinous ligament arc tangent guided freehand thoracic pedicle screw insertion technique: high parallelism between screws and upper endplate
Research objectiveTo propose a technique for placing pedicle screws in the thoracic spine using the Supraspinous ligament Arc Tangent (SLAT) as a guide to increase the safety and stability of screw placement.Content and methodsA retrospective analysis of postoperative anteroposterior and lateral x-r...
| Main Authors: | , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Frontiers Media S.A.
2023-08-01
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| Series: | Frontiers in Surgery |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/articles/10.3389/fsurg.2023.1219816/full |
| _version_ | 1827874846055333888 |
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| author | Fushuai Peng Meng Gao Qiang Li Zhensong Jiang Fei Chen Mingtong Sun Yudong Lai Haoyu Wang Xingpeng Wang Tao Li Wen Zhang |
| author_facet | Fushuai Peng Meng Gao Qiang Li Zhensong Jiang Fei Chen Mingtong Sun Yudong Lai Haoyu Wang Xingpeng Wang Tao Li Wen Zhang |
| author_sort | Fushuai Peng |
| collection | DOAJ |
| description | Research objectiveTo propose a technique for placing pedicle screws in the thoracic spine using the Supraspinous ligament Arc Tangent (SLAT) as a guide to increase the safety and stability of screw placement.Content and methodsA retrospective analysis of postoperative anteroposterior and lateral x-ray images was performed for 118 patients with thoracic spine diseases who received conventional freehand technique from January 2016 to May 2020 and SLAT-guided technique since June 2020 to present. The diagnoses included thoracic spinal stenosis, deformity, fractures, infections, and tumors. The angle between the screw and the upper endplate was categorized as grade 1 (0°–5°), grade 2 (5°–10°), and grade 3 (>10°). Three surgeons with more than 10 years of experience in spinal surgery measured the angle between the screw and the upper endplate in the lateral view. Chi-square test was used for statistical analysis, and p < 0.05 was considered statistically significant.ResultsA total of 1315 pedicle screws were placed from T1 to T12 in all patients. In the conventional freehand technique group, 549 screws were grade 1, 35 screws were grade 2, and 23 screws were grade 3. In the SLAT-guided freehand technique group, 685 screws were grade 1, 15 screws were grade 2, and 8 screws were grade 3. The data of each group was p < 0.05 by Chi-squared test, which was statistically significant, indicating that the SLAT-guided freehand technique resulted in a higher rate of parallelism between the screws and the upper endplate. All patients underwent intraoperative neurophysiological monitoring, immediate postoperative neurological examination, postoperative x-ray examination, and assess the eventual recovery. The screws were safe and stable, and no complications related to pedicle screw placement were found.ConclusionThe SLAT-guided freehand technique for placing pedicle screws in the thoracic spine can achieve a higher rate of screw-upper endplate parallelism, making screw placement safer and more accurate. Our method provides a convenient and reliable technique for most spinal surgeons, allowing for increased accuracy and safety with less fluoroscopic guidance. |
| first_indexed | 2024-03-12T16:57:45Z |
| format | Article |
| id | doaj.art-6a4653094b8b4952997bb0353efdd4cb |
| institution | Directory Open Access Journal |
| issn | 2296-875X |
| language | English |
| last_indexed | 2024-03-12T16:57:45Z |
| publishDate | 2023-08-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Surgery |
| spelling | doaj.art-6a4653094b8b4952997bb0353efdd4cb2023-08-07T20:50:22ZengFrontiers Media S.A.Frontiers in Surgery2296-875X2023-08-011010.3389/fsurg.2023.12198161219816Supraspinous ligament arc tangent guided freehand thoracic pedicle screw insertion technique: high parallelism between screws and upper endplateFushuai Peng0Meng Gao1Qiang Li2Zhensong Jiang3Fei Chen4Mingtong Sun5Yudong Lai6Haoyu Wang7Xingpeng Wang8Tao Li9Wen Zhang10Department of Spine Surgery, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, ChinaDepartment of Spine Surgery, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, ChinaDepartment of Radiology, The Second Affiliated Hospital of Shandong First Medical University, Taian, ChinaDepartment of Spine Surgery, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, ChinaDepartment of Spine Surgery, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, ChinaDepartment of Spine Surgery, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, ChinaDepartment of Spine Surgery, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, ChinaDepartment of Spine Surgery, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, ChinaDepartment of Spine Surgery, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, ChinaDepartment of Spine Surgery, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, ChinaDepartment of Spine Surgery, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, ChinaResearch objectiveTo propose a technique for placing pedicle screws in the thoracic spine using the Supraspinous ligament Arc Tangent (SLAT) as a guide to increase the safety and stability of screw placement.Content and methodsA retrospective analysis of postoperative anteroposterior and lateral x-ray images was performed for 118 patients with thoracic spine diseases who received conventional freehand technique from January 2016 to May 2020 and SLAT-guided technique since June 2020 to present. The diagnoses included thoracic spinal stenosis, deformity, fractures, infections, and tumors. The angle between the screw and the upper endplate was categorized as grade 1 (0°–5°), grade 2 (5°–10°), and grade 3 (>10°). Three surgeons with more than 10 years of experience in spinal surgery measured the angle between the screw and the upper endplate in the lateral view. Chi-square test was used for statistical analysis, and p < 0.05 was considered statistically significant.ResultsA total of 1315 pedicle screws were placed from T1 to T12 in all patients. In the conventional freehand technique group, 549 screws were grade 1, 35 screws were grade 2, and 23 screws were grade 3. In the SLAT-guided freehand technique group, 685 screws were grade 1, 15 screws were grade 2, and 8 screws were grade 3. The data of each group was p < 0.05 by Chi-squared test, which was statistically significant, indicating that the SLAT-guided freehand technique resulted in a higher rate of parallelism between the screws and the upper endplate. All patients underwent intraoperative neurophysiological monitoring, immediate postoperative neurological examination, postoperative x-ray examination, and assess the eventual recovery. The screws were safe and stable, and no complications related to pedicle screw placement were found.ConclusionThe SLAT-guided freehand technique for placing pedicle screws in the thoracic spine can achieve a higher rate of screw-upper endplate parallelism, making screw placement safer and more accurate. Our method provides a convenient and reliable technique for most spinal surgeons, allowing for increased accuracy and safety with less fluoroscopic guidance.https://www.frontiersin.org/articles/10.3389/fsurg.2023.1219816/fullfreehand techniqueSupraspinous ligament Arc Tangentthoracic pediclescrewsparallelism |
| spellingShingle | Fushuai Peng Meng Gao Qiang Li Zhensong Jiang Fei Chen Mingtong Sun Yudong Lai Haoyu Wang Xingpeng Wang Tao Li Wen Zhang Supraspinous ligament arc tangent guided freehand thoracic pedicle screw insertion technique: high parallelism between screws and upper endplate Frontiers in Surgery freehand technique Supraspinous ligament Arc Tangent thoracic pedicle screws parallelism |
| title | Supraspinous ligament arc tangent guided freehand thoracic pedicle screw insertion technique: high parallelism between screws and upper endplate |
| title_full | Supraspinous ligament arc tangent guided freehand thoracic pedicle screw insertion technique: high parallelism between screws and upper endplate |
| title_fullStr | Supraspinous ligament arc tangent guided freehand thoracic pedicle screw insertion technique: high parallelism between screws and upper endplate |
| title_full_unstemmed | Supraspinous ligament arc tangent guided freehand thoracic pedicle screw insertion technique: high parallelism between screws and upper endplate |
| title_short | Supraspinous ligament arc tangent guided freehand thoracic pedicle screw insertion technique: high parallelism between screws and upper endplate |
| title_sort | supraspinous ligament arc tangent guided freehand thoracic pedicle screw insertion technique high parallelism between screws and upper endplate |
| topic | freehand technique Supraspinous ligament Arc Tangent thoracic pedicle screws parallelism |
| url | https://www.frontiersin.org/articles/10.3389/fsurg.2023.1219816/full |
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