OBJECT: To validate computerized tomography (CT) scanning as a tool to assess the accuracy of thoracic pedicle screw placement, the authors compared its accuracy with that of direct visualization in instrumented cadaveric spine specimens. METHODS: A grading scale was devised to score the placement of the pedicle screw. The grades ranged from 0 to 3 depending on the extent to which the pedicle had been violated. One hundred fifty-five pedicles were fitted with instrumentation in eight cadaveric spines. A single observer graded the appearance of the screw based on CT scans (3-mm axial sections with 1-mm overlap) and direct visualization of the specimen. The authors arrived at a Kappa value of 0.51, which suggested only moderate agreement between the two measurement techniques. Whereas CT had a positive predictive value of 95%, it had a negative predictive value of 62%. CONCLUSIONS: The authors thus conclude that although CT scanning is the most valid tool to assess the accuracy of thoracic pedicle screw placement, it tends to overestimate the number of misplaced screws.
OBJECT: To validate computerized tomography (CT) scanning as a tool to assess the accuracy of thoracic pedicle screw placement, the authors compared its accuracy with that of direct visualization in instrumented cadaveric spine specimens. METHODS: A grading scale was devised to score the placement of the pedicle screw. The grades ranged from 0 to 3 depending on the extent to which the pedicle had been violated. One hundred fifty-five pedicles were fitted with instrumentation in eight cadaveric spines. A single observer graded the appearance of the screw based on CT scans (3-mm axial sections with 1-mm overlap) and direct visualization of the specimen. The authors arrived at a Kappa value of 0.51, which suggested only moderate agreement between the two measurement techniques. Whereas CT had a positive predictive value of 95%, it had a negative predictive value of 62%. CONCLUSIONS: The authors thus conclude that although CT scanning is the most valid tool to assess the accuracy of thoracic pedicle screw placement, it tends to overestimate the number of misplaced screws.
Authors: Heiko Koller; Frank Acosta; Mark Tauber; Michael Fox; Hudelmaier Martin; Rosmarie Forstner; Peter Augat; Rainer Penzkofer; Christian Pirich; H Kässmann; Herbert Resch; Wolfgang Hitzl Journal: Eur Spine J Date: 2008-01-26 Impact factor: 3.134
Authors: David T Raphael; Jin Ho Chang; Yao Ping Zhang; David Kudija; Thomas C Chen; K Kirk Shung Journal: Spine J Date: 2010-03-27 Impact factor: 4.166
Authors: Miguel Pishnamaz; Thomas Dienstknecht; Barbara Hoppe; Christina Garving; Henning Lange; Frank Hildebrand; Philipp Kobbe; Hans-Christoph Pape Journal: Int Orthop Date: 2015-08-11 Impact factor: 3.075