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Published in: European Spine Journal 11/2017

01-11-2017 | Ideas and Technical Innovations

S2-AI screw placement with the aide of electronic conductivity device monitoring: a retrospective analysis

Authors: Faheem A. Sandhu, Jason E. McGowan, Daniel R. Felbaum, Hasan R. Syed, Kyle B. Mueller

Published in: European Spine Journal | Issue 11/2017

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Abstract

Study design

A retrospective analysis of two consecutive patients who underwent a novel surgical technique.

Objective

A report of a novel surgical technique utilizing an electronic conductivity device guidance to aide placement of S2-Alar-Iliac (S2-AI) instrumentation.

Summary of background data

Electronic conductivity guidance for instrumentation of the thoracolumbar spine is an accepted means of improving intraoperative accuracy. Although commercially available for percutaneous techniques, there is a paucity of literature regarding its use. Percutaneous implantation of S2-AI screws has been previously described as another technique surgeons can avail, primarily employing fluoroscopy as a means of intraoperative feedback. We describe a novel technique that utilizes electronic conductivity as an added feedback measure to increase accuracy of percutaneous S2-AI fixation.

Methods

Two patients were treated by the senior author (FAS) who underwent surgery employing S2-AI fixation utilizing an electronic conductivity device (Pediguard cannulated probe, Spineguard, Paris, France). The surgical technique, case illustrations, and radiographic outcomes are discussed.

Results

Stable and accurate fixation was attained in both patients. There were no peri-operative complications related to hardware placement.

Conclusion

To the authors’ knowledge, this is the first reported literature combining S2-AI screws with electronic conductivity for immediate intraoperative feedback. This technique has the opportunity to provide surgeons with increased accuracy for placement of S2-AI screws while improving overall radiation safety. This feedback can be particularly helpful when surgeons are learning new techniques such as placement of S2AI screws.
Literature
1.
go back to reference Schwab FJ, Blondel B, Bess S et al (2013) Radiographical spinopelvic parameters and disability in the setting of adult spinal deformity: a prospective multicenter analysis. Spine (Phila Pa 1976) 38(13):E803–E812. doi:10.1097/BRS.0b013e318292b7b9 CrossRef Schwab FJ, Blondel B, Bess S et al (2013) Radiographical spinopelvic parameters and disability in the setting of adult spinal deformity: a prospective multicenter analysis. Spine (Phila Pa 1976) 38(13):E803–E812. doi:10.​1097/​BRS.​0b013e318292b7b9​ CrossRef
2.
go back to reference Manwaring JC, Bach K, Ahmadian AA, Deukmedjian AR, Smith DA, Uribe JS (2014) Management of sagittal balance in adult spinal deformity with minimally invasive anterolateral lumbar interbody fusion: a preliminary radiographic study. J Neurosurg Spine 20:1–8. doi:10.3171/2014.2.SPINE1347 CrossRef Manwaring JC, Bach K, Ahmadian AA, Deukmedjian AR, Smith DA, Uribe JS (2014) Management of sagittal balance in adult spinal deformity with minimally invasive anterolateral lumbar interbody fusion: a preliminary radiographic study. J Neurosurg Spine 20:1–8. doi:10.​3171/​2014.​2.​SPINE1347 CrossRef
3.
go back to reference Surgery O, Francisco S, Diego S (2012) Impact of spinopelvic alignment on decision making in deformity surgery in adults. J Neurosurg Spine 16:547–564CrossRef Surgery O, Francisco S, Diego S (2012) Impact of spinopelvic alignment on decision making in deformity surgery in adults. J Neurosurg Spine 16:547–564CrossRef
4.
go back to reference Moshirfar A, Rand FF, Sponseller PD et al (2005) Pelvic fixation in spine surgery. Historical overview, indications, biomechanical relevance, and current techniques. J Bone Joint Surg Am 87(Suppl 2):89–106. doi:10.2106/JBJS.E.00453 PubMed Moshirfar A, Rand FF, Sponseller PD et al (2005) Pelvic fixation in spine surgery. Historical overview, indications, biomechanical relevance, and current techniques. J Bone Joint Surg Am 87(Suppl 2):89–106. doi:10.​2106/​JBJS.​E.​00453 PubMed
5.
go back to reference Ovadia D, Korn A, Fishkin M, Steinberg DM, Wientroub S, Ofiram E (2011) The contribution of an electronic conductivity device to the safety of pedicle screw insertion in scoliosis surgery. Spine (Phila Pa 1976) 36(20):E1314–E1321. doi:10.1097/BRS.0b013e31822a82ec CrossRef Ovadia D, Korn A, Fishkin M, Steinberg DM, Wientroub S, Ofiram E (2011) The contribution of an electronic conductivity device to the safety of pedicle screw insertion in scoliosis surgery. Spine (Phila Pa 1976) 36(20):E1314–E1321. doi:10.​1097/​BRS.​0b013e31822a82ec​ CrossRef
6.
go back to reference Chaput CD, George K, Samdani AF, Williams JI, Gaughan J, Betz RR (2012) Reduction in radiation (fluoroscopy) while maintaining safe placement of pedicle screws during lumbar spine fusion. Spine (Phila Pa 1976) 37(21):E1305–E1309. doi:10.1097/BRS.0b013e3182666adc CrossRef Chaput CD, George K, Samdani AF, Williams JI, Gaughan J, Betz RR (2012) Reduction in radiation (fluoroscopy) while maintaining safe placement of pedicle screws during lumbar spine fusion. Spine (Phila Pa 1976) 37(21):E1305–E1309. doi:10.​1097/​BRS.​0b013e3182666adc​ CrossRef
7.
8.
go back to reference Bai Y-S, Niu Y-F, Chen Z-Q et al (2012) Comparison of the pedicle screws placement between electronic conductivity device and normal pedicle finder in posterior surgery of scoliosis. J Spinal Disord Tech 00(00):1. doi:10.1097/BSD.0b013e318247f21d Bai Y-S, Niu Y-F, Chen Z-Q et al (2012) Comparison of the pedicle screws placement between electronic conductivity device and normal pedicle finder in posterior surgery of scoliosis. J Spinal Disord Tech 00(00):1. doi:10.​1097/​BSD.​0b013e318247f21d​
10.
go back to reference Smith ZA, Sugimoto K, Lawton CD, Fessler RG (2012) Incidence of lumbar spine pedicle breach following percutaneous screw fixation: a radiographic evaluation of 601 screws in 151 patients. J Spinal Disord Tech 27:358–363. doi:10.1097/BSD.0b013e31826226cb CrossRef Smith ZA, Sugimoto K, Lawton CD, Fessler RG (2012) Incidence of lumbar spine pedicle breach following percutaneous screw fixation: a radiographic evaluation of 601 screws in 151 patients. J Spinal Disord Tech 27:358–363. doi:10.​1097/​BSD.​0b013e31826226cb​ CrossRef
14.
15.
go back to reference Chaput CD, George K, Samdani AF, Williams JI, Gaughan J, Betz RR (2012) Reduction in radiation (fluoroscopy) while maintaining safe placement of pedicle screws during lumbar spine fusion. Spine 37(21):1305–1309CrossRef Chaput CD, George K, Samdani AF, Williams JI, Gaughan J, Betz RR (2012) Reduction in radiation (fluoroscopy) while maintaining safe placement of pedicle screws during lumbar spine fusion. Spine 37(21):1305–1309CrossRef
16.
go back to reference Guillen PT, Knopper RG, Kroger J, Wycliffe ND, Danisa OA, Cheng WK (2014) Independent assessment of a new pedicle probe and its ability to detect pedicle breach: a cadaveric study. J Neurosurg Spine 21:1–5. doi:10.3171/2014.6.SPINE131028 CrossRef Guillen PT, Knopper RG, Kroger J, Wycliffe ND, Danisa OA, Cheng WK (2014) Independent assessment of a new pedicle probe and its ability to detect pedicle breach: a cadaveric study. J Neurosurg Spine 21:1–5. doi:10.​3171/​2014.​6.​SPINE131028 CrossRef
19.
go back to reference Jain A, Hassanzadeh H, Strike SA, Menga EN, Sponseller PD, Kebaish KM (2015) Pelvic fixation in adult and pediatric spine surgery: historical perspective, indications, and techniques. JBJS 97:1521–1528CrossRef Jain A, Hassanzadeh H, Strike SA, Menga EN, Sponseller PD, Kebaish KM (2015) Pelvic fixation in adult and pediatric spine surgery: historical perspective, indications, and techniques. JBJS 97:1521–1528CrossRef
24.
go back to reference Chen G, Li H, Li F, Chen W, Chen Q (2012) Learning curve of thoracic pedicle screw placement using the free-hand technique in scoliosis: How many screws needed for an apprentice? Eur Spine J 21(6):1151–1156. doi:10.1007/s00586-011-2065-2 CrossRef Chen G, Li H, Li F, Chen W, Chen Q (2012) Learning curve of thoracic pedicle screw placement using the free-hand technique in scoliosis: How many screws needed for an apprentice? Eur Spine J 21(6):1151–1156. doi:10.​1007/​s00586-011-2065-2 CrossRef
25.
go back to reference Syed H et al (2014) The use of an electrical conductivity-monitoring device (ECMD) shortens the learning curve for accurate placement of pedicle screws: a cadaveric study. Poster presented at the annual meeting of congress of neurological surgeons, Boston Syed H et al (2014) The use of an electrical conductivity-monitoring device (ECMD) shortens the learning curve for accurate placement of pedicle screws: a cadaveric study. Poster presented at the annual meeting of congress of neurological surgeons, Boston
Metadata
Title
S2-AI screw placement with the aide of electronic conductivity device monitoring: a retrospective analysis
Authors
Faheem A. Sandhu
Jason E. McGowan
Daniel R. Felbaum
Hasan R. Syed
Kyle B. Mueller
Publication date
01-11-2017
Publisher
Springer Berlin Heidelberg
Published in
European Spine Journal / Issue 11/2017
Print ISSN: 0940-6719
Electronic ISSN: 1432-0932
DOI
https://doi.org/10.1007/s00586-017-5242-0

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