Image-Guidance Technology Reduces Pedicle Screw Revision Rates

Researchers investigated the intraoperative revision and reoperation rates of lumbar pedicle screw placement using either an image-guided open or percutaneous placement method and found the imaging technology reduced revision rates and the rate of malpositioned pedicle screws.

The Minnesota researchers reviewed 199 cases of 3-D image-guided lumbar pedicle screw instrumentation from November 2006 to December 2011, noting screw or K-wire removal, repositioning or eventual abandonment of insertion. The researchers determined statistical significance between the rates of the two groups using Chi-square test.

Results showed the overall intraoperative revision rate of image-guided screws was 4.6 percent. Significantly more revisions were needed in the patients with percutaneously inserted screws (7.5 percent) compared with those in whom the open technique was used (2.7 percent); however, if K-wire revisions were removed from the totals, there was no statistically significant difference in intraoperative revision rates between the percutaneous and open groups (2.1 percent vs. 2.7 percent), according to the data. There were also no reoperations for malpositioned screws.

The analysis concluded the technology may eliminate the need for reoperation of malpositioned screws and may be a more cost-effective way of preventing neurovascular injuries and revision surgery.