Minimally invasive percutaneous transpedicular screw fixation: Increased accuracy and reduced radiation exposure by means of a novel electromagnetic navigation system

Ron Von Jako, Michael A. Finn, Kenneth S. Yonemura, Ali Araghi, Larry T. Khoo, John A. Carrino, Mick Perez-Cruet

Research output: Contribution to journalArticle

Abstract

Background: Minimally invasive percutaneous pedicle screw instrumentation methods may increase the need for intraoperative fluoroscopy, resulting in excessive radiation exposure for the patient, surgeon, and support staff. Electromagnetic field (EMF)-based navigation may aid more accurate placement of percutaneous pedicle screws while reducing fluoroscopic exposure. We compared the accuracy, time of insertion, and radiation exposure of EMF with traditional fluoroscopic percutaneous pedicle screw placement. Methods: Minimally invasive pedicle screw placement in T8 to S1 pedicles of eight fresh-frozen human cadaveric torsos was guided with EMF or standard fluoroscopy. Set-up, insertion, and fluoroscopic times and radiation exposure and accuracy (measured with post-procedural computed tomography) were analyzed in each group. Results: Sixty-two pedicle screws were placed under fluoroscopic guidance and 60 under EMF guidance. Ideal trajectories were achieved more frequently with EMF over all segments (62.7% vs. 40%; p=0.01). Greatest EMF accuracy was achieved in the lumbar spine, with significant improvements in both ideal trajectory and reduction of pedicle breaches over fluoroscopically guided placement (64.9% vs. 40%, p=0.03, and 16.2% vs. 42.5%, p=0.01, respectively). Fluoroscopy time was reduced 77% with the use of EMF (22 s vs. 5 s per level; p

Original languageEnglish (US)
Pages (from-to)589-596
Number of pages8
JournalActa Neurochirurgica
Volume153
Issue number3
DOIs
StatePublished - Mar 2011

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Electromagnetic Fields
Electromagnetic Phenomena
Fluoroscopy
Torso
Radiation Exposure
Spine
Tomography
Pedicle Screws

Keywords

  • Accuracy
  • Electromagnetic field navigation
  • Fluoroscopy
  • Minimally invasive
  • Pedicle screw

ASJC Scopus subject areas

  • Clinical Neurology
  • Surgery

Cite this

Minimally invasive percutaneous transpedicular screw fixation : Increased accuracy and reduced radiation exposure by means of a novel electromagnetic navigation system. / Von Jako, Ron; Finn, Michael A.; Yonemura, Kenneth S.; Araghi, Ali; Khoo, Larry T.; Carrino, John A.; Perez-Cruet, Mick.

In: Acta Neurochirurgica, Vol. 153, No. 3, 03.2011, p. 589-596.

Research output: Contribution to journalArticle

Von Jako, Ron ; Finn, Michael A. ; Yonemura, Kenneth S. ; Araghi, Ali ; Khoo, Larry T. ; Carrino, John A. ; Perez-Cruet, Mick. / Minimally invasive percutaneous transpedicular screw fixation : Increased accuracy and reduced radiation exposure by means of a novel electromagnetic navigation system. In: Acta Neurochirurgica. 2011 ; Vol. 153, No. 3. pp. 589-596.
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