Abstract：
BACKGROUND: Percutaneous pedicle screw (PPS) placement has become a pivotal technique in spinal surgery, increasing surgical efficiency and limiting the invasiveness of surgical procedures. The aim of this study was to analyze the accuracy of computer-assisted PPS placement with a standardized technique in the lateral decubitus position.
METHODS: A retrospective review of prospectively collected data was performed on 44 consecutive patients treated between 2021 and 2023 with lateral decubitus single-position surgery. PPS placement was assessed by computed tomography scans, and breaches were graded based on the magnitude and direction of the breach. Facet joint violations were assessed. Variables collected included patient demographics, indication, intraoperative complications, operative time, fluoroscopy time, estimated blood loss, and length of stay.
RESULTS: Forty-four patients, with 220 PPSs were identified. About 79.5% of all patients underwent anterior lumbar interbody fusion only, 13.6% underwent lateral lumbar interbody fusion only, and 6.8% received a combination of both anterior lumbar interbody fusion and lateral lumbar interbody fusion. Eleven screw breaches (5%) were identified: 10 were Grade II breaches (<2 mm), and 1 was a Grade IV breach (>4 mm). All breaches were lateral. About 63.6% involved down-side screws indicating a trend toward the laterality of breaches for down-side pedicles. When analyzing breaches by level, 1.2% of screws at L5, 13% at L4, and 11.1% at L3 demonstrated Grade II breaches. No facet joint violations were noted.
CONCLUSIONS: PPS placement utilizing computer-assisted navigation in lateral decubitus single-position surgery is both safe and accurate. An overall breach rate of 5% was found; considering a safe zone of 2 mm, only 1 screw (0.5%) demonstrated a relevant breach.
CONCLUSIONS: PPS placement is both safe and accurate. Breaches are rare, and when breaches do occur, they are lateral.
METHODS:
METHODS: A retrospective review of prospectively collected data was performed on 44 consecutive patients treated between 2021 and 2023 with lateral decubitus single-position surgery. PPS placement was assessed by computed tomography scans, and breaches were graded based on the magnitude and direction of the breach. Facet joint violations were assessed. Variables collected included patient demographics, indication, intraoperative complications, operative time, fluoroscopy time, estimated blood loss, and length of stay.
RESULTS: Forty-four patients, with 220 PPSs were identified. About 79.5% of all patients underwent anterior lumbar interbody fusion only, 13.6% underwent lateral lumbar interbody fusion only, and 6.8% received a combination of both anterior lumbar interbody fusion and lateral lumbar interbody fusion. Eleven screw breaches (5%) were identified: 10 were Grade II breaches (<2 mm), and 1 was a Grade IV breach (>4 mm). All breaches were lateral. About 63.6% involved down-side screws indicating a trend toward the laterality of breaches for down-side pedicles. When analyzing breaches by level, 1.2% of screws at L5, 13% at L4, and 11.1% at L3 demonstrated Grade II breaches. No facet joint violations were noted.
CONCLUSIONS: PPS placement utilizing computer-assisted navigation in lateral decubitus single-position surgery is both safe and accurate. An overall breach rate of 5% was found; considering a safe zone of 2 mm, only 1 screw (0.5%) demonstrated a relevant breach.
CONCLUSIONS: PPS placement is both safe and accurate. Breaches are rare, and when breaches do occur, they are lateral.
METHODS:
摘要：
背景：经皮椎弓根螺钉（PPS）的放置已成为脊柱外科的关键技术，提高手术效率和限制外科手术的侵入性。这项研究的目的是在侧卧位中使用标准化技术分析计算机辅助PPS放置的准确性。
方法：对2021年至2023年接受侧卧位单位置手术治疗的44例连续患者进行了前瞻性收集的数据的回顾性回顾。PPS的放置是通过计算机断层扫描来评估的，根据违规的程度和方向对违规进行分级。评估了各方面的联合违规行为。收集的变量包括患者人口统计，指示,术中并发症,手术时间,透视时间,估计失血量,和逗留时间的长短。
结果：44名患者，确定了220个PPSs。约79.5%的患者仅接受腰椎前路椎间融合术,13.6%的人只接受了腰椎外侧椎间融合术，6.8%的患者同时接受了前路腰椎间融合术和外侧腰椎间融合术。确定了11个螺钉破裂（5％）：10个为II级破裂（<2毫米），1为四级裂口(>4毫米)。所有的缺口都是横向的。大约63.6％的人涉及向下的螺钉，这表明向下的椎弓根的破裂呈偏侧趋势。按级别分析漏洞时，L5处1.2%的螺钉、L4处13%的螺钉和L3处11.1%的螺钉显示出II级破裂。没有发现任何方面的共同侵权行为。
结论：在侧卧位单位置手术中利用计算机辅助导航放置PPS既安全又准确。发现总体破口率为5%；考虑到2毫米的安全区，只有1个螺钉（0.5％）显示出相关的违规行为。
结论：PPS放置既安全又准确。违约是罕见的，当违规发生时，它们是横向的。
方法：
方法：对2021年至2023年接受侧卧位单位置手术治疗的44例连续患者进行了前瞻性收集的数据的回顾性回顾。PPS的放置是通过计算机断层扫描来评估的，根据违规的程度和方向对违规进行分级。评估了各方面的联合违规行为。收集的变量包括患者人口统计，指示,术中并发症,手术时间,透视时间,估计失血量,和逗留时间的长短。
结果：44名患者，确定了220个PPSs。约79.5%的患者仅接受腰椎前路椎间融合术,13.6%的人只接受了腰椎外侧椎间融合术，6.8%的患者同时接受了前路腰椎间融合术和外侧腰椎间融合术。确定了11个螺钉破裂（5％）：10个为II级破裂（<2毫米），1为四级裂口(>4毫米)。所有的缺口都是横向的。大约63.6％的人涉及向下的螺钉，这表明向下的椎弓根的破裂呈偏侧趋势。按级别分析漏洞时，L5处1.2%的螺钉、L4处13%的螺钉和L3处11.1%的螺钉显示出II级破裂。没有发现任何方面的共同侵权行为。
结论：在侧卧位单位置手术中利用计算机辅助导航放置PPS既安全又准确。发现总体破口率为5%；考虑到2毫米的安全区，只有1个螺钉（0.5％）显示出相关的违规行为。
结论：PPS放置既安全又准确。违约是罕见的，当违规发生时，它们是横向的。
方法：
