Akademik Veri Yönetim Sistemi
Journal of Neurological Surgery, Part A: Central European Neurosurgery, cilt.86, sa.1, ss.1-11, 2023 (SCI-Expanded, Scopus)
Background: Transpedicular screw (TPS) misplacement is still a nightmare for spine surgeons. Preoperative planning is one of the methods that a surgeon could use to minimize this complication. This study aims to compare three-dimensional (3D) and two-dimensional (2D) preoperative planning in posterior lumbar TPSs placement performed using the freehand technique. Patients and methods: Patients who underwent posterior TPSs placement for degenerative lumbar spondylolisthesis or spinal stenosis using the freehand technique between November 2021 and October 2022 were evaluated retrospectively. 33 and 30 patients met study criteria and consecutively operated on with preoperative 2D (2DG) and 3D (3DG) planning, respectively. Both groups were compared. Results: 63 patients were operated on at the setting hospital during the study period. There was no significant difference between the groups regarding blood transfusion, operation time, and radiation exposure. Although the accuracy of TPSs positioning was 94.2 % and 96.5% in the 2DG and 3DG, the difference between the groups was not statistically significant. The upper facet joint violation rate was 12.8% (n = 20) in the 2DG versus 3.5% (n = 5) in the 3DG (p = 0.006). All L4 TPSs were inserted with their standard entry points without any modification [(p < 0.0001; RR = 0.64]. The modification rate was higher in L1, L2, and L5 TPSs (p < 0.0001; X2 = 24.7). Conclusion: For patients with degenerative lumbar diseases, 3D preoperative planning in posterior lumbar instrumentation surgeries that were performed with the freehand technique decreased the upper facet joint violation rate.