BACKGROUND More studies report the intraoperative benefits vs. risks of utilizing the O-Arm in performing pedicle screw insertion in spinal surgery. METHODS/RESULTS Several studies document the utility of CT-guided O-arm placement of pedicle/lateral mass screws. Singh et al. documented the efficacy of CT guided-O Arm placement of pedicle screws and lateral mass screws in the upper cervical sp...

STUDY DESIGN A cadaveric laboratory study. OBJECTIVE The aim of this study was to assess the feasibility and accuracy of thoracic pedicle screw placement using augmented reality surgical navigation (ARSN). SUMMARY OF BACKGROUND DATA Recent advances in spinal navigation have shown improved accuracy in lumbosacral pedicle screw placement but limited benefits in the thoracic spine. 3D intraope...

Anatomical measurements of the cervical pedicle in a large series of human cervical vertebrae from 48 individuals were obtained to reduce the incidence and severity of complications caused by transpedicular screw placement. The greatest pedicle length was at C-3 and the greatest pedicle width was at C-6. Pedicle width and lateral mass thickness gradually increased from C-3 to C-6. Pedicle heigh...

The reported incidence of lumbar pedicle screw malpositioning is between 5 and 40%. Post-operative neural deficits related to screw misplacement have been reported at rates between 3 and 11%. Radiography alone is an unreliable tool for determining pedicle wall violation due to malpositioned screws, whether by intra-operative fluoroscopy, plain X-ray, imageguided surgery systems based on radiogr...

BACKGROUND There is no study concerning safety and accuracy of pedicle screw placement in Marfan syndrome. The objective of this study is to investigate accuracy and safety of pedicle screw placement in scoliosis associated with Marfan syndrome. METHODS CT scanning was performed to analyze accuracy of pedicle screw placement. Pedicle perforations were classified as medial, lateral or anterior...

To review existing publications on the safety of pedicle screw insertions in adolescent idiopathic scoliosis (AIS). Despite having increased risk for neurological and visceral injuries, the use of pedicle screws have led to increased correction rates in scoliosis surgery. A review was performed on topics pertinent to pedicle screw insertion in AIS, which included pedicle morphometry in AIS, str...

STUDY DESIGN Prospective randomized controlled trial. OBJECTIVE The aim of this study was to monitor the quality control of robot-assisted pedicle screw fixation accuracy by using a cumulative summation (CUSUM) test at the initial stage of its application. SUMMARY OF BACKGROUND DATA Although robot-assisted pedicle screw fixation reduces screw misplacement rates and provides critical support...

We are developing a robotic system to assist a surgeon in placing spinal pedicle screws. While several groups have undertaken such systems, our approach differs in that it endeavors to remain as close to current clinical technique as possible, yet achieve stereotactic accuracy. This paper describes the conventional surgical methodology, justifies the need for stereotactic/robotic assistance, an...

STUDY DESIGN We performed a prospective study to evaluate the reliability of using triggered electromyography (EMG) for predicting pedicle wall breakthrough during the placement of pedicle screw in adolescent idiopathic scoliosis surgery. PURPOSE We wanted to correlate pedicle wall breakthrough with the triggered EMG threshold of stimulation and the postoperative computed tomography (CT) find...