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Related Experiment Video

Updated: May 19, 2026

Pedicle Screw Placement Using an Augmented Reality Head-Mounted Display in a Porcine Model
06:18

Pedicle Screw Placement Using an Augmented Reality Head-Mounted Display in a Porcine Model

Published on: May 24, 2024

Lumbar pedicle screw placement: Using only AP plane imaging.

Anil Sethi1, Adrienne Lee, Rahul Vaidya

  • 1Department of Orthopaedic Surgery, Investigation Performed at Detroit Receiving Hospital, Detroit, MI, USA.

Indian Journal of Orthopaedics
|August 23, 2012
PubMed
Summary

This study shows that using only AP plane fluoroscopy and tactile guidance for pedicle screw placement is a safe and efficient alternative to CT scans. This technique offers reliable results for spinal fusion surgery.

Keywords:
AP imagingLumbar spinefluoroscopypedicle screw

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Area of Science:

  • Orthopedic Surgery
  • Neurosurgery
  • Spinal Surgery

Background:

  • Pedicle screw placement can be challenging due to variations in pedicle morphology and spinal deformities.
  • Computerized tomography (CT)-guided screw placement improves accuracy but is time-consuming and expensive.
  • This study explores an alternative technique using single-plane fluoroscopy and tactile guidance.

Purpose of the Study:

  • To evaluate the safety, efficiency, and accuracy of pedicle screw placement using single-plane fluoroscopy in the AP projection combined with tactile guidance.
  • To present the results of this technique in lumbar spinal fusion surgeries.

Main Methods:

  • A retrospective study of 308 patients (1806 pedicle screws) undergoing lumbar spinal fusion.
  • Pedicle screws were placed using fluoroscopy in the AP plane alone, with a final lateral image.
  • Postoperative radiographs were performed, and CT scans were obtained for 78 patients (588 screws).

Main Results:

  • Twenty-nine (5%) cortical wall perforations were identified among 588 screws evaluated by CT, with no resulting vascular or neural complications.
  • Anterior cortical violation occurred in 14 patients, and lateral wall penetration in 9 patients.
  • Medial wall encroachment was noted in six patients without frank perforations.

Conclusions:

  • Pedicle screw placement using AP plane fluoroscopic guidance and tactile guidance is safe, fast, and reliable.
  • This technique provides an efficient alternative to more time-consuming and expensive methods.
  • A thorough understanding of radiographic landmarks is essential for successful implementation.