Cervical Spine Pedicle Screw Accuracy in Fluoroscopic, Navigated and Template Guided Systems—A Systematic Review
<i>Background:</i> Pedicle screws provide excellent fixation for a wide range of indications. However, their adoption in the cervical spine has been slower than in the thoracic and lumbar spine, which is largely due to the smaller pedicle sizes and the proximity to the neurovascular stru...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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MDPI AG
2021-10-01
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| Series: | Tomography |
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| Online Access: | https://www.mdpi.com/2379-139X/7/4/52 |
| _version_ | 1797500259017949184 |
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| author | Arin Mahmoud Kanatheepan Shanmuganathan Brett Rocos Fady Sedra Alexander Montgomery Syed Aftab |
| author_facet | Arin Mahmoud Kanatheepan Shanmuganathan Brett Rocos Fady Sedra Alexander Montgomery Syed Aftab |
| author_sort | Arin Mahmoud |
| collection | DOAJ |
| description | <i>Background:</i> Pedicle screws provide excellent fixation for a wide range of indications. However, their adoption in the cervical spine has been slower than in the thoracic and lumbar spine, which is largely due to the smaller pedicle sizes and the proximity to the neurovascular structures in the neck. In recent years, technology has been developed to improve the accuracy and thereby the safety of cervical pedicle screw placement over traditional fluoroscopic techniques, including intraoperative 3D navigation, computer-assisted Systems and 3D template moulds. We have performed a systematic review into the accuracy rates of the various systems. <i>Methods:</i> The PubMed and Cochrane Library databases were searched for eligible papers; 9 valid papers involving 1427 screws were found. <i>Results:</i> fluoroscopic methods achieved an 80.6% accuracy and navigation methods produced 91.4% and 96.7% accuracy for templates. <i>Conclusion:</i> Navigation methods are significantly more accurate than fluoroscopy, they reduce radiation exposure to the surgical team, and improvements in technology are speeding up operating times. Significantly superior results for templates over fluoroscopy and navigation are complemented by reduced radiation exposure to patient and surgeon; however, the technology requires a more invasive approach, prolonged pre-operative planning and the development of an infrastructure to allow for their rapid production and delivery. We affirm the superiority of navigation over other methods for providing the most accurate and the safest cervical pedicle screw instrumentation, as it is more accurate than fluoroscopy and lacks the limitations of templates. |
| first_indexed | 2024-03-10T03:59:20Z |
| format | Article |
| id | doaj.art-c894014999174557801c8cfe9b9d195c |
| institution | Directory Open Access Journal |
| issn | 2379-1381 2379-139X |
| language | English |
| last_indexed | 2024-03-10T03:59:20Z |
| publishDate | 2021-10-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Tomography |
| spelling | doaj.art-c894014999174557801c8cfe9b9d195c2023-11-23T10:49:01ZengMDPI AGTomography2379-13812379-139X2021-10-017461462210.3390/tomography7040052Cervical Spine Pedicle Screw Accuracy in Fluoroscopic, Navigated and Template Guided Systems—A Systematic ReviewArin Mahmoud0Kanatheepan Shanmuganathan1Brett Rocos2Fady Sedra3Alexander Montgomery4Syed Aftab5Trauma and Orthopaedic Department, Royal London Hospital, London E1 1FR, UKTrauma and Orthopaedic Department, Royal London Hospital, London E1 1FR, UKTrauma and Orthopaedic Department, Royal London Hospital, London E1 1FR, UKTrauma and Orthopaedic Department, Royal London Hospital, London E1 1FR, UKTrauma and Orthopaedic Department, Royal London Hospital, London E1 1FR, UKTrauma and Orthopaedic Department, Royal London Hospital, London E1 1FR, UK<i>Background:</i> Pedicle screws provide excellent fixation for a wide range of indications. However, their adoption in the cervical spine has been slower than in the thoracic and lumbar spine, which is largely due to the smaller pedicle sizes and the proximity to the neurovascular structures in the neck. In recent years, technology has been developed to improve the accuracy and thereby the safety of cervical pedicle screw placement over traditional fluoroscopic techniques, including intraoperative 3D navigation, computer-assisted Systems and 3D template moulds. We have performed a systematic review into the accuracy rates of the various systems. <i>Methods:</i> The PubMed and Cochrane Library databases were searched for eligible papers; 9 valid papers involving 1427 screws were found. <i>Results:</i> fluoroscopic methods achieved an 80.6% accuracy and navigation methods produced 91.4% and 96.7% accuracy for templates. <i>Conclusion:</i> Navigation methods are significantly more accurate than fluoroscopy, they reduce radiation exposure to the surgical team, and improvements in technology are speeding up operating times. Significantly superior results for templates over fluoroscopy and navigation are complemented by reduced radiation exposure to patient and surgeon; however, the technology requires a more invasive approach, prolonged pre-operative planning and the development of an infrastructure to allow for their rapid production and delivery. We affirm the superiority of navigation over other methods for providing the most accurate and the safest cervical pedicle screw instrumentation, as it is more accurate than fluoroscopy and lacks the limitations of templates.https://www.mdpi.com/2379-139X/7/4/52cervical spinepedicle screw |
| spellingShingle | Arin Mahmoud Kanatheepan Shanmuganathan Brett Rocos Fady Sedra Alexander Montgomery Syed Aftab Cervical Spine Pedicle Screw Accuracy in Fluoroscopic, Navigated and Template Guided Systems—A Systematic Review Tomography cervical spine pedicle screw |
| title | Cervical Spine Pedicle Screw Accuracy in Fluoroscopic, Navigated and Template Guided Systems—A Systematic Review |
| title_full | Cervical Spine Pedicle Screw Accuracy in Fluoroscopic, Navigated and Template Guided Systems—A Systematic Review |
| title_fullStr | Cervical Spine Pedicle Screw Accuracy in Fluoroscopic, Navigated and Template Guided Systems—A Systematic Review |
| title_full_unstemmed | Cervical Spine Pedicle Screw Accuracy in Fluoroscopic, Navigated and Template Guided Systems—A Systematic Review |
| title_short | Cervical Spine Pedicle Screw Accuracy in Fluoroscopic, Navigated and Template Guided Systems—A Systematic Review |
| title_sort | cervical spine pedicle screw accuracy in fluoroscopic navigated and template guided systems a systematic review |
| topic | cervical spine pedicle screw |
| url | https://www.mdpi.com/2379-139X/7/4/52 |
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