Comparative analysis of the accuracy of pedicle screw insertion in surgical treatment of children with idiopathic scoliosis

Abstract

Objective. To perform comparative analysis of the accuracy of pedicle screw placement in spinal deformity correction in children with idio- pathic scoliosis using 3D-CT navigation. Material and Methods. Surgical treatment of 96 patients aged 14–18 years with Lenke type I and V idiopathic scoliosis was performed. In the study group (n = 66), pedicle screws were inserted using the navigation station, in the control group (n = 30) – by the freehand method. The accuracy of pedicle screw position was assessed using postoperative CT images of the spine based on the Gertzbein scale. Results. The total number of pedicle screws inserted in the study group was 1166, in the control group – 546. In the study group, position of screws was correct in 96 % (1119 screws) of observations and incorrect in 4 % (47 screws). In the control group, the correct position was noted only in 78 % (426 screws) of cases, and the number of incorrectly inserted screws was significantly larger – 22 % (120 screws). In the study group, incorrectly inserted screws in the thoracic spine were detected in 4.8 % of cases, in the lumbar spine – in 2.5 %; in the control group, pedicle screws were incorrectly inserted in the thoracic spine in 35.1 % of cases, in the lumbar spine – in 10.1 %. Conclusion. Using the navigation station during surgical intervention aimed at correcting the deformity of the spine in children with idio- pathic scoliosis of various locations allows a significant increase in the number of correctly inserted pedicle screws used for instrumentation.

Keywords

• idiopathic scoliosis
• transpedicular fixation
• navigation
• children