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- W4300688545 abstract "Study Design: Retrospective cohort study. Objective: To investigate the accuracy of pedicle screw placement by freehand technique and to compare revision surgery rates among three different imaging verification pathways. Summary of Background Data: Studies comparing different imaging modalities in freehand screw placement surgery are limited. Methods: A single-institution retrospective chart review identified adult patients who underwent freehand pedicle screw placement in the thoracic, lumbar or sacral levels. Patients were stratified into three cohorts based on the intraoperative imaging modality used to assess the accuracy of screw position: intraoperative X-Rays (cohort 1); intraoperative O-arm (cohort 2); or intraoperative CT-scan (cohort 3). Postoperative CT-scans were performed on all patients in cohorts 1 and 2. Postoperative CT-scan was not required in cohort 3. Screw accuracy was assessed using the Gertzbein-Robbins grading system. Results: 9,179 pedicle screws were placed in the thoracic or lumbosacral spine in 1311 patients. 210 (2.3%) screws were identified as Gertzbein-Robbins grades C-E on intra/post-operative CT-scan, 137 thoracic screws , and 73 lumbar screws (P<0.001). 409 patients underwent placement of 2,754 screws followed by intraoperative X-Ray (cohort 1); 793 patients underwent placement of 5,587 screws followed by intraoperative O-arm (cohort 2); and 109 patients underwent placement of 838 screws followed by intraoperative CT-scan (cohort 3). Postoperative CT-scans identified 65 (2.4%) and 127 (2.3%) malpositioned screws in cohorts 1 and 2, respectively. 11 screws (0.12%) were significantly malpositioned and required a second operation for screw revision. 9 patients (0.69%) required revision operations: 8 of these patients were from cohort 1 and 1 patient was from cohort 2. Conclusion: When compared to intraoperative X-Ray, intraoperative O-arm verification decreased the revision surgery rate for malpositioned screws from 0.37% to 0.02%. In addition, our analysis suggests that the use of intraoperative O-arm can obviate the need for postoperative CT scans." @default.
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- W4300688545 date "2022-09-28" @default.
- W4300688545 modified "2023-10-14" @default.
- W4300688545 title "Safety and Accuracy of Freehand Pedicle Screw Placement and the Role of Intraoperative O-Arm" @default.
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- W4300688545 doi "https://doi.org/10.1097/brs.0000000000004497" @default.
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