PMID- 36308545
OWN - NLM
STAT- MEDLINE
DCOM- 20221216
LR  - 20240223
IS  - 1432-0932 (Electronic)
IS  - 0940-6719 (Linking)
VI  - 31
IP  - 12
DP  - 2022 Dec
TI  - Pedicle screw placement safety with the aid of patient-specific guides in a case 
      series of patients with thoracic scoliosis.
PG  - 3544-3550
LID - 10.1007/s00586-022-07427-0 [doi]
AB  - PURPOSE: Pedicle screw (PS) placement in thoracic scoliotic deformities can be 
      challenging due to altered vertebral anatomy; malposition can result in severe 
      functional disability or inferior construct stability. Three-dimensional (3D) 
      printed patient-specific guides (PSGs) have been recently used to supplement 
      other PS placement techniques. We conducted a single-center, retrospective 
      observational study to assess the accuracy of PS placement using PSGs in a 
      consecutive case series of pediatric and adult patients with thoracic scoliosis. 
      METHODS: We analyzed the data of patients with thoracic scoliosis who underwent 
      PS placement using 3D-printed PSG as a vertebral cannulation aid between June 
      2013 and July 2018. PS positions were determined via Gertzbein-Robbins (GR) and 
      Heary classifications on computed tomography images. We determined the 
      concordance of actual and preoperatively planned PS positions and defined the 
      technique learning curve using a receiver-operating characteristic (ROC) curve. 
      RESULTS: We performed 362 thoracic PS placement procedures in 39 consecutive 
      patients. We classified 352 (97.2%), 2 (0.6%), and 8 (2.2%) screws as GR grades 0 
      (optimal placement), I, and II, respectively. The average instrumented PS entry 
      point offsets on the X- and Y-axes were both 0.8 mm, and the average differences 
      in trajectory between the planned and the actual screw placements on the oblique 
      sagittal and oblique transverse planes were 2.0 degrees  and 2.4 degrees , respectively. The 
      learning process was ongoing until the first 12 PSs were placed. CONCLUSIONS: The 
      accuracy of PS placement using patient-specific 3D templates in our case series 
      exceeds the accuracies of established thoracic PS placement techniques.
CI  - (c) 2022. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, 
      part of Springer Nature.
FAU - Mohar, Janez
AU  - Mohar J
AUID- ORCID: 0000-0002-6228-3929
AD  - Department of Spine Surgery, Valdoltra Orthopedic Hospital, Jadranska C. 31, 
      6280, Ankaran, Europe, Slovenia. janez.mohar@ob-valdoltra.si.
AD  - Chair of Orthopedics, Medical Faculty, University of Ljubljana, Ljubljana, 
      Slovenia. janez.mohar@ob-valdoltra.si.
FAU - Valic, Matej
AU  - Valic M
AUID- ORCID: 0000-0002-4500-5652
AD  - Department of Spine Surgery, Valdoltra Orthopedic Hospital, Jadranska C. 31, 
      6280, Ankaran, Europe, Slovenia.
FAU - Podovsovnik, Eva
AU  - Podovsovnik E
AUID- ORCID: 0000-0001-7449-7038
AD  - Department of Spine Surgery, Valdoltra Orthopedic Hospital, Jadranska C. 31, 
      6280, Ankaran, Europe, Slovenia.
FAU - Mihalic, Rene
AU  - Mihalic R
AUID- ORCID: 0000-0003-2649-5913
AD  - Department of Spine Surgery, Valdoltra Orthopedic Hospital, Jadranska C. 31, 
      6280, Ankaran, Europe, Slovenia.
AD  - Chair of Orthopedics, Medical Faculty, University of Ljubljana, Ljubljana, 
      Slovenia.
LA  - eng
PT  - Journal Article
PT  - Observational Study
DEP - 20221029
PL  - Germany
TA  - Eur Spine J
JT  - European spine journal : official publication of the European Spine Society, the 
      European Spinal Deformity Society, and the European Section of the Cervical Spine 
      Research Society
JID - 9301980
SB  - IM
MH  - Adult
MH  - Humans
MH  - Child
MH  - *Pedicle Screws
MH  - *Scoliosis/diagnostic imaging/surgery
MH  - *Spinal Fusion/methods
MH  - Spine/surgery
MH  - *Surgery, Computer-Assisted
MH  - Retrospective Studies
MH  - Thoracic Vertebrae/diagnostic imaging/surgery
OTO - NOTNLM
OT  - Patient-specific guides
OT  - Pedicle screw placement accuracy
OT  - Thoracic scoliosis
OT  - Three-dimensional printing
EDAT- 2022/10/30 06:00
MHDA- 2022/12/15 06:00
CRDT- 2022/10/29 11:13
PHST- 2022/02/11 00:00 [received]
PHST- 2022/10/11 00:00 [accepted]
PHST- 2022/09/21 00:00 [revised]
PHST- 2022/10/30 06:00 [pubmed]
PHST- 2022/12/15 06:00 [medline]
PHST- 2022/10/29 11:13 [entrez]
AID - 10.1007/s00586-022-07427-0 [pii]
AID - 10.1007/s00586-022-07427-0 [doi]
PST - ppublish
SO  - Eur Spine J. 2022 Dec;31(12):3544-3550. doi: 10.1007/s00586-022-07427-0. Epub 
      2022 Oct 29.