Free-Hand Pedicle Screw Placement Using a Ball Tip Widening Technique for Small Pedicles.

Area of Science:

• Orthopedic Surgery
• Spinal Instrumentation
• Pediatric Orthopedics

Background:

• Pedicle screw placement is crucial for spinal fusion success.
• Accurate screw insertion is challenging, especially in pediatric patients with smaller anatomy.
• Existing techniques may have limitations in achieving optimal pedicle screw positioning.

Purpose of the Study:

• To evaluate the accuracy and validity of the novel "ball tip widening technique" for pedicle screw insertion.
• To assess the efficacy of this technique in pediatric scoliosis correction surgery.

Main Methods:

• Retrospective analysis of 212 pedicle screws used in pediatric scoliosis correction surgery.
• Screws were inserted using posterior spinal instrumentation and fusion.
• Intraoperative computed tomography (CT) with an O-arm was utilized for accuracy assessment.

Main Results:

• 86.8% (184/212) of pedicle screws were accurately placed within the pedicle.
• The ball tip widening technique demonstrated effectiveness in enhancing screw insertion accuracy.
• The technique shows promise for improving pedicle screw placement in challenging cases.

Conclusions:

• The ball tip widening technique is an accurate and valid method for pedicle screw insertion.
• This technique can improve screw accuracy, particularly in small pedicles common in pediatric patients.
• Future applications may include lumbar degenerative spine surgery.