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Open Access 01-12-2022 | Research

Cortical screw placement with a spinous process clamp guide: a cadaver study accessing accuracy

Authors: Xi-nuo Zhang, Yi-qi Zhang, Yu-zeng Liu, Qing-jun Su, Li Guan, Dong-yue Li, Bao-qing Pei, Ai-xing Pan, Hong-hao Yang, Hong-tao Ding, Yong Hai, Li-jin Zhou

Published in: BMC Surgery | Issue 1/2022

Abstract

Background and objective

The Cortical Bone Trajectory (CBT) technique provides an alternative method for fixation in the lumbar spine in patients with osteoporosis. An accuracy CBT screw placement could improve mechanical stability and reduce complication rates.

Purpose

The purpose of this study is to explore the accuracy of cortical screw placement with the application of implanted spinous process clip (SPC) guide.

Methods and materials

Four lumbar specimens with T12-S1 were used to access the accuracy of the cortical screw. The SPC-guided planning screws were compared to the actual inserted screws by superimposing the vertebrae and screws preoperative and postoperative CT scans. According to preoperative planning, the SPC guide was adjusted to the appropriate posture to allow the K-wire drilling along the planned trajectory. Pre and postoperative 3D-CT reconstructions was used to evaluate the screw accuracy according to Gertzbein and Robbins classification. Intraclass correlation coefficients (ICCs) and Bland–Altman plots were used to examine SPC-guided agreements for CBT screw placement.

Results

A total of 48 screws were documented in the study. Clinically acceptable trajectory (grades A and B) was accessed in 100% of 48 screws in the planning screws group, and 93.8% of 48 screws in the inserted screws group (p = 0.242). The incidence of proximal facet joint violation (FJV) in the planning screws group (2.1%) was comparable to the inserted screws group (6.3%) (p = 0.617). The lateral angle and cranial angle of the planned screws (9.2 ± 1.8° and 22.8 ± 5.6°) were similar to inserted screws (9.1 ± 1.7° and 23.0 ± 5.1°, p = 0.662 and p = 0.760). Reliability evaluated by intraclass correlation coefficients and Bland–Altman showed good consistency in cranial angle and excellent results in lateral angle and distance of screw tip.

Conclusions

Compared with preoperative planning screws and the actually inserted screws, the SPC guide could achieve reliable execution for cortical screw placement.

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Title: Cortical screw placement with a spinous process clamp guide: a cadaver study accessing accuracy
Authors: Xi-nuo Zhang
Yi-qi Zhang
Yu-zeng Liu
Qing-jun Su
Li Guan
Dong-yue Li
Bao-qing Pei
Ai-xing Pan
Hong-hao Yang
Hong-tao Ding
Yong Hai
Li-jin Zhou
Publication date: 01-12-2022
Publisher: BioMed Central
Published in: BMC Surgery / Issue 1/2022
Electronic ISSN: 1471-2482
DOI: https://doi.org/10.1186/s12893-022-01829-z

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Cortical screw placement with a spinous process clamp guide: a cadaver study accessing accuracy

Abstract

Background and objective

Purpose

Methods and materials

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background and objective

Purpose

Methods and materials

Results

Conclusions

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