Accuracy in Percutaneous Transpedicular Screws Placement Using Biplane Radioscopy: Systematic Review and Meta-Analysis.
Clin Spine Surg
; 32(5): 198-207, 2019 06.
Article
em En
| MEDLINE
| ID: mdl-30762838
ABSTRACT
STUDY DESIGN:
Systematic review and descriptive data meta-analysis.OBJECTIVE:
The objective of this study was to appropriately establish the accuracy in the percutaneous transpedicular screws (PTS) placement using biplane radioscopy (Rx-2D). SUMMARY OF BACKGROUND DATA The Rx-2D is a widely-used technique for PTS as it is practical, ubiquitous, and cost-effective. However, the reported "acceptable" accuracy attained by this method is widely variable ranging between 76% and 100%.METHODS:
A systematic review was conducted to screen publications about PTS placement using Rx-2D guidance. PubMed/MEDLINE database was consulted using the search term "percutaneous pedicle screw" from 1977 to 2017. Previous meta-analysis and reference lists of the selected articles were reviewed. Accuracy values were assessed fulfilling the proposed criteria. Observational data meta-analysis was performed. Cochran's Q test was used to determine heterogeneity among data extracted from the series, which was quantified by I test. P-values≤0.05 were considered statistically significant. The results were depicted by Forest plots. Funnel plots were outlined to visualize a possible bias of publication among the selected articles.RESULTS:
In total, 27 articles were included in the analysis. Results of the accuracy were as follow, 91.5% (n=7993; 95% CI, 89.3%-93.6%) of the screws were placed purely intrapedicular, and 96.1% (n=8579; 95% CI, 94.0%-98.2%) when deviation from the pedicle was up to 2 mm.CONCLUSIONS:
This meta-analysis is the largest review of PTS placed with Rx-2D guidance reported up to date. We concluded that the procedure is a safe and reproducible technique. The key values obtained in this work set reliable references for both clinical and training outcome assessing.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Fluoroscopia
/
Parafusos Pediculares
Tipo de estudo:
Guideline
/
Systematic_reviews
Limite:
Humans
Idioma:
En
Revista:
Clin Spine Surg
Ano de publicação:
2019
Tipo de documento:
Article