A New Pilot Hole Preparation System for Percutaneous Pedicle Screw Placement: A Randomized Controlled Study

Area of Science:

• Spine surgery
• Orthopedic surgery
• Minimally invasive spinal techniques

Background:

• Accurate, rapid, and safe pedicle screw placement is crucial for minimally invasive lumbar interbody fusion (LIF).
• Optimizing pilot hole preparation instruments is key to improving clinical outcomes in LIF procedures.
• Reducing radiation exposure for patients and surgical teams is a priority in spinal surgery.

Purpose of the Study:

• To introduce and evaluate a novel pilot hole preparation system for percutaneous pedicle screw placement.
• To compare the efficiency and safety of the new system against the conventional method in LIF surgery.
• To assess the impact of the new system on procedure time, radiation exposure, and screw accuracy.

Main Methods:

• A randomized controlled study involving 60 patients (180 screws) undergoing single-level LIF.
• Patients were randomized into two groups: new pilot hole system versus conventional method.
• Data collected included pilot hole preparation time, screw placement time, fluoroscopy time, and screw accuracy (Gertzbein-Robbins scale).

Main Results:

• The new system significantly reduced pilot hole preparation time (4.08 vs. 5.34 min, P <0.001).
• Screw placement time (0.82 vs. 1.72 min) and fluoroscopy time (13.70 vs. 19.95 s) were also significantly shorter with the new system (P <0.001).
• Screw accuracy was higher with the new system, with 94.45% A-grade screws compared to 84.44% in the conventional group (P =0.027).

Conclusions:

• The new pilot hole preparation system offers significant advantages in reducing procedure time and radiation exposure.
• The system demonstrates improved screw placement accuracy in percutaneous pedicle screw fixation.
• The novel system shows considerable clinical value for minimally invasive lumbar interbody fusion procedures.