Does use of pre-operative low-dose CT-scan in adolescent idiopathic scoliosis improve accuracy in screw placement? Results of a retrospective study.
Idiopathic adolescent scoliosis
Pedicle screw accuracy
Pedicle screw malpositioning
Pre-operative CT
Scoliosis
Journal
Spine deformity
ISSN: 2212-1358
Titre abrégé: Spine Deform
Pays: England
ID NLM: 101603979
Informations de publication
Date de publication:
09 2021
09 2021
Historique:
received:
14
12
2020
accepted:
29
03
2021
pubmed:
10
4
2021
medline:
20
11
2021
entrez:
9
4
2021
Statut:
ppublish
Résumé
To evaluate the efficacy of pre-operative low-dose radiation computed tomography (CT) in optimizing screw placement in patients with adolescent idiopathic scoliosis (AIS). 49 patients with AIS who required correction and posterior fusion between January 2018 and December 2019 were included in this retrospective study. All patients underwent surgery performed by the same team of experienced surgeons. Patients were divided in two groups. The study group received a pre-operative low-dose CT scan (CT group, n = 25), differently from the control group (CG, n = 24). Patients of both groups received a post-operative low-dose CT scan. The primary outcome measure was the accuracy of screw placement on the Gertzbein-Robbins scale (grades A and B were considered acceptable). Secondary outcome measures included a comparison of perioperative complications. A total of 1045 screws were placed. In CT group (n = 25, screws = 528) and CG (n = 24, screws = 517), trajectories were grade A or B in 94.5% and 93.6% of screws, respectively. Two screws (one for each group) were removed because of intra-operative-evoked potentials alteration and one screw required revision after post-operative imaging. No correlation was found between the malpositioning rate and the proximity to the apex of the curve, conversely a significative peak of misplacements was observed at T3 (p < 0.01). No neurological and vascular complications related to screw placement were recorded. There was not intergroup difference neither in screw accuracy (Chi-Square, 2-tailed Fisher's exact, p = 0.63), nor in complications rate. Pre-operative low-dose CT scan as surgical plan does not contribute in reducing pedicle screw misplacement rate. Retrospective comparative cohort study. III.
Identifiants
pubmed: 33835428
doi: 10.1007/s43390-021-00343-1
pii: 10.1007/s43390-021-00343-1
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1403-1410Informations de copyright
© 2021. Scoliosis Research Society.
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