Safety and Efficacy of Intraoperative Doppler Sonography-Assisted Cervical Pedicle Screw Fixation-A Retrospective Comparison with Conventional Pedicle Screw Implantation

Overview

Journal Global Spine J

Publisher Sage Publications

Date 2022 Feb 23

PMID 35193407

Authors

Sang Hyo Lee

Jong-Hyeok Park

Jong Beom Lee

Ho Jin Lee

Il Sup Kim

Jeong Woo Hur

Jae Taek Hong

Affiliations

Soon will be listed here.

Abstract

Study Design: A Retrospective Cohort Study.

Objective: To introduce a new Doppler sonography-assisted pedicle screw fixation technique that enables vertebral artery (VA) monitoring during surgery and compares the accuracies of Doppler sonography-assisted cervical pedicle screw fixation and the conventional technique.

Methods: This retrospective study was performed on 164 consecutive patients that underwent pedicle-based screw fixation from C2 to C6 between January 2013 and August 2020. Surgery was performed without intraoperative Doppler sonography in 84 cases (the Control group) or with intraoperative Doppler sonography in 80 cases (the Doppler group). Proper positioning of pedicle screws was graded, and the incidences of VA injury and screw breach in the Control and Doppler groups were compared.

Results: Three hundred and ninety-nine screws were placed in the 164 patients (Doppler, 186 screws; Control, 213 screws). The percentages of well-positioned screws in the two groups were significantly different (Doppler, 97.8%; Control, 85.0%). There were two cases of VA injury in the Control group, an incidence of 2.4%, but no case in the Doppler group.

Conclusion: Doppler sonography can be used intraoperatively to help guide the trajectory of the cervical pedicle screw insertion. It can detect the VA inside the screw trajectory and may reduce the risk of VA injury during cervical pedicle screw fixation.

Citing Articles

A novel radiographic analysis system for subaxial cervical spine pedicle screw placement.

Ding B, Zhou T, Ma H, Zhao J J Orthop Surg Res. 2023; 18(1):581.

PMID: 37553693 PMC: 10408217. DOI: 10.1186/s13018-023-03999-9.

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