Intraoperative 3-D imaging can improve accuracy of pedicle screw placement in spine surgery

A study at Hospital for Special Surgery (HSS) found that intraoperative three-dimensional (3D) imaging was superior to two-dimensional radiographs in confirming the accuracy of pedicle screw placement during spine surgery. The research was presented today at the American Academy of Orthopaedic Surgeons (AAOS) Annual Meeting in Las Vegas.
Many spinal surgeries require the use of implants called pedicle screws to stabilize the spine. Precise positioning of these screws is critical for a successful outcome. “Two-dimensional biplanar radiographs [BPR] have been the gold standard to confirm pedicle screw placement in spine fusion surgery for many years. However, when utilizing BPR, there is the potential that a two-dimensional image alone will not properly demonstrate the successful placement of a screw,” said Darren Lebl, MD, a spine surgeon at HSS and principal investigator of the study. “As an alternative, three-dimensional intraoperative imaging systems are now available, offering improved visualization.”
Dr. Lebl and colleagues set out to compare the accuracy of BPR versus 3D imaging when assessing intraoperative pedicle screw placement. “Our study is the first to compare the differences in intraoperative biplanar radiography and 3D imaging for pedicle screw accuracy in thoracic and lumbar cases using robotic technology,” Dr. Lebl noted.
Investigators analyzed data from 103 patients who underwent spinal fusion by a single surgeon from 2019 to 2022. Pedicle screw placement was assessed with both intraoperative BPR and 3D imaging in each case.
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