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In vitro simulation. Early results of stereotaxy for pedicle screw placement
A L Carl1, H S Khanuja, B L Sachs
1Division of Orthopaedic Surgery, Albany Medical College, New York, USA.
Study Design:
Frameless stereotaxy with doppler ultrasound and three dimensional computer model registration is assessed in vitro for pedicle screw placement.
Objective:
To identify feasibility of pedicle screw navigation and placement using this technology.
Summary Of Background Data:
Inaccurate pedicle screw placement can lead to neurovascular injury or suboptimal fixation. Present techniques in pedicle screw placement involve only confirmation of hole orientation.
Method:
Forty-four pedicle screws were placed in lumbosacral models and cadaver specimens. Accuracy was assessed with a computed tomography scan and vertebral cross sectioning.
Results:
All screws were intrapedicular. Accuracy of anterior cortical fixation was 1.5 mm, with a range of 2.5 mm.
Conclusion:
In vitro frameless stereotaxy is accurate for pedicle screw placement. This technology adds a component of navigation to pedicle screw placement.