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Comparative Study
. 2015 Sep 8:21:2672-7.
doi: 10.12659/MSM.894074.

Comparing Accuracy of Cervical Pedicle Screw Placement between a Guidance System and Manual Manipulation: A Cadaver Study

Yu Cong  1 , Nirong Bao  1 , Jianning Zhao  1 , Guangping Mao  1
Affiliations
Comparative Study

Comparing Accuracy of Cervical Pedicle Screw Placement between a Guidance System and Manual Manipulation: A Cadaver Study

Yu Cong et al. Med Sci Monit. .

Abstract

Background: The aim of this study was to compare the accuracy of cervical pedicle screw placement between a three-dimensional guidance system and manual manipulation.

Material and methods: Eighteen adult cadavers were randomized into group A (n=9) and group B (n=9). Ninety pedicle screws were placed into the C3-C7 under the guidance of a three-dimensional locator in group A, and 90 screws were inserted by manual manipulation in group B. The cervical spines were scanned using computed tomography (CT). Parallel and angular offsets of the screws were compared between the two placement methods.

Results: In group A, 90% of the screws were within the pedicles and 10% breached the pedicle cortex. In group B, 55.6% were within the pedicle and 44.4% breached the pedicle cortex. Locator guidance showed significantly lower parallel and angular offsets in axial CT images (P<0.01), and significantly lower angular offset in sagittal CT images (P<0.01) than manual manipulation.

Conclusions: Locator guidance is superior to manual manipulation in accuracy of cervical screw placement. Locator guidance might provide better safety than manual manipulation in placing cervical screws.

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Figures

Figure 1
Figure 1
There were significant differences between group A and B in the axial CT images and between the axial and sagittal CT images of group A. There were no significant difference between group A and B in the axial CT images or between axial and sagittal CT images of group B.
Figure 2
Figure 2
There were significant differences between group A and B in the axial and sagittal CT image and between axial and sagittal CT images of group A. There was no significant difference between axial and sagittal CT images of group B.
See this image and copyright information in PMC

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