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Updated: May 8, 2026
An Anesthesia, Surgery, and Harvest Method for the Evaluation of Transpedicular Screws Using an In Vivo Porcine Lumbar Spine Model
Published on: May 31, 2017
DensiProbe Spine: an intraoperative measurement of bone quality in spinal instrumentation. A clinical feasibility
Albrecht W Popp1, Ronald Schwyn, Damiano Schiuma
1Department of Osteoporosis, Inselspital, Berne University Hospital and University of Berne, Freiburgstrasse, 3010 Bern, Switzerland.
Background Context:
A new device, DensiProbe, has been developed to provide surgeons with intraoperative information about bone strength by measuring the peak breakaway torque. In cases of low bone quality, the treatment can be adapted to the patient's condition, for example, by improving screw-anchorage with augmentation techniques.
Purpose:
The objective of this study was to investigate the feasibility of DensiProbe Spine in patients undergoing transpedicular fixation.
Study Design:
Prospective feasibility study on consecutive patients.
Patient Sample:
Fourteen women and 16 men were included in this study.
Outcome Measures:
Local and general bone quality.
Methods:
These consecutive patients scheduled for transpedicular fixation were evaluated for bone mineral density (BMD), which was measured globally by dual-energy X-ray absorptiometry and locally via biopsies using quantitative microcomputed tomography. The breakaway torque force within the vertebral body was assessed intraoperatively via the transpedicular approach with the DensiProbe Spine. The results were correlated with the areal BMD at the lumbar spine and the local volumetric BMD (vBMD) and a subjective impression of bone strength. The feasibility of the method was evaluated, and the clinical and radiological performance was evaluated over a 1-year follow-up. This study was funded by an AO Spine research grant; DensiProbe was developed at the AO Research Institute Davos, Switzerland; the AO Foundation is owner of the intellectual property rights.
Results:
In 30 patients, 69 vertebral levels were examined. The breakaway torque consistently correlated with an experienced surgeon's quantified impression of resistance as well as with vBMD of the same vertebra. Beyond a marginal prolongation of surgery time, no adverse events related to the usage of the device were observed.
Conclusions:
The intraoperative transpedicular measurement of the peak breakaway torque was technically feasible, safe, and reliably predictive of local vBMD during dorsal spinal instrumentations in a clinical setting. Larger studies are needed to define specific thresholds that indicate a need for the augmentation or instrumentation of additional levels.
