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Related Experiment Video

Updated: Sep 2, 2025

Pedicle Screw Placement Using an Augmented Reality Head-Mounted Display in a Porcine Model
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Bone conductivity and spine fluoroscopy, Hand-Eye-Ear dialogue, during pedicle screw positioning: a new human

Harkirat Bhogal1, Sagi Martinov1, Pauline Buteau1

  • 1Orthopedic Department, EpiCURA Baudour Hornu Ath Hospital, Saint-Ghislain, Hainaut, Belgium.

International Orthopaedics
|August 5, 2022
PubMed
Summary

The Pediguard system, using impedancemetry, reduced fluoroscopy time by 50% for novice surgeons during pedicle screw placement. While experienced surgeons saw no significant radiation reduction, the system aids trainees in minimizing radiation exposure.

Keywords:
Artificial intelligenceBone conductivityEar-hand coordinationEye-hand coordinationMachine learningPediguardScrewing pedicleSpine fluoroscopySpine radiation

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Area of Science:

  • Spine surgery
  • Surgical technology
  • Medical imaging

Background:

  • Minimizing intra-operative radiation exposure is crucial in spinal surgery.
  • Accurate pedicle screw placement is essential for spinal fixation.
  • The Pediguard system offers impedancemetry-guided guidance to detect pedicle wall penetration.

Purpose of the Study:

  • To compare intra-operative radiation dose between the Pediguard system and standard free-hand technique.
  • To evaluate the effectiveness of impedancemetry-guided pedicle positioning in reducing radiation exposure.
  • To assess the impact of surgeon experience (trainee vs. expert) on radiation dose and screw placement time.

Main Methods:

  • A prospective randomized study involving 20 patients.
  • Two groups: Pediguard-guided versus free-hand pedicle screw placement.
  • Data collected included screw placement time, fluoroscopic time, and post-operative CT analysis for screw accuracy.

Main Results:

  • 22 unrecognized pedicle perforations were detected by CT scan among 104 screws.
  • Pediguard did not significantly increase screw placement time for experienced surgeons but added 2 minutes per screw for novice surgeons.
  • For novice surgeons, Pediguard reduced fluoroscopy time from 12s to 6s per screw, a 50% decrease.

Conclusions:

  • The Pediguard system can significantly reduce fluoroscopy time for novice surgeons during pedicle screw placement.
  • While experienced surgeons did not show significant radiation reduction, the system aids trainees.
  • Further research may explore optimizing Pediguard use across different surgical experience levels.