Accuracy of percutaneous pedicle screw placement with 3-dimensional fluoroscopy-based navigation: Lateral decubitus position versus prone position. Issue 14 (7th April 2023)

• Record Type: Journal Article
• Authors: Okuda, Ryuichiro; Ikuma, Hisanori; Inoue, Tomohiro; Ueda, Masataka; Hirose, Tomohiko; Otsuka, Kazutoshi; Kawasaki, Keisuke
• Is Part Of: Medicine. Volume 102:Issue 14(2023)
• Page Start: e33451
• Publication Date: 2023-04-07
• Subjects: 3D fluoroscopy-based navigation system -- accuracy -- downside PPS -- lateral decubitus position -- percutaneous pedicle screw -- PPS deviation -- PPS insertion -- prone position -- single-position spine surgery -- upside PPS; Medicine -- Periodicals; Medicine -- Periodicals; Médecine -- Périodiques; Geneeskunde; Medicine; Periodicals; Periodicals; 610.5
• DOI: 10.1097/MD.0000000000033451
• Languages: English
• ISSNs: 0025-7974

Abstract

Abstract : The accuracy of percutaneous pedicle screw (PSS) placement in the lateral decubitus position has seldom been reported. This study aimed to retrospectively compare the accuracy of PPS placement with 3-dimensional (3D) fluoroscopy-based navigation in 2 cohorts of patients who underwent surgery in the lateral decubitus or prone positions at our single institute. A total of 265 consecutive patients underwent spinal surgery with PPS from T1 (thoracic 1) to S (sacrum) under the 3D fluoroscopy-based navigation system at our institute. Patients were divided into 2 groups based on their intraoperative patient positioning: lateral decubitus (Group L) or prone (Group P). A total of 1816 PPSs were placed from T1 to S, and 76 (4.18%) PPSs were assessed as deviated PPS. Twenty-one of 453 (4.64%) PPSs in Group L deviation and 55 of 1363 (4.04%) PPSs in Group P had deviated PPS, but with not significant difference ( P = .580). In Group L, although the PPS deviation rate was not significantly different between the upside and downside PPS, the downside PPS significantly deviated toward the lateral side compared with the upside PPS. The safety and efficacy of PPS insertion in the lateral decubitus position were similar to those in the conventional prone position.