Ensuring the safety of surgical correction of scoliosis in children using neuromonitoring and O-arm navigation

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Abstract

Severe multiplanar spinal deformities of various etiologies are accompanied by disorders of the organ systems, causing early disability and reduced life expectancy of patients, which, in turn, dictates the need for surgical correction. The method of choice for the surgical correction of scoliosis is the technology of three-dimensional polysegmental fixation according to Cotrel–Dubousset. Despite the advantages of this spinal stabilization technology, it has its own specific difficulties and risks of various complications, most often associated with malposition of the supporting elements. To reduce the number of complications associated with the surgical correction of scoliosis, methods have been developed, including intraoperative neuromonitoring and O-arm navigation, the effectiveness of which will be discussed in this article.

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About the authors

Ivan P. Pimburskiy

National Medical Research Center for Children’s Health

Email: bdfyltvbljd@yandex.ru
ORCID iD: 0009-0002-5274-3941

Graduate Student

Russian Federation, Moscow

Andrey S. Butenko

National Medical Research Center for Children’s Health

Email: butenko.as@nczd.ru
ORCID iD: 0000-0002-7542-8218

Traumatologist-Orthopedist

Russian Federation, Moscow

Konstantin A. Samokhin

Orenburg State Medical University; City Clinical Hospital №4

Email: ksamohin25@mail.ru
ORCID iD: 0009-0002-4292-8782

Assistant of Professor

Orenburg; Orenburg

Oleg B. Сhelpachenko

National Medical Research Center for Children’s Health; Research Institute of Emergency Pediatric Surgery and Traumatology

Email: Chelpachenko81@mail.ru
ORCID iD: 0000-0002-0333-3105

D. Sci. (Med.)

Russian Federation, Moscow; Moscow

Konstantin V. Zherdev

National Medical Research Center for Children’s Health; Sechenov First Moscow State Medical University (Sechenov University)

Email: drzherdev@mail.ru
ORCID iD: 0000-0003-3698-6011

D. Sci. (Med.)

Russian Federation, Moscow; Moscow

Sergey P. Yatsyk

National Medical Research Center for Children’s Health

Email: makadamia@yandex.ru
ORCID iD: 0000-0001-6966-1040

D. Sci. (Med.), Prof., Corr. Memb. RAS

Russian Federation, Moscow

Pavel A. Zubkov

National Medical Research Center for Children’s Health

Email: zpa992@gmail.com
ORCID iD: 0000-0001-9408-8004

Traumatologist-Orthopedist

Russian Federation, Moscow

Alexander A. Petelguzov

National Medical Research Center for Children’s Health

Author for correspondence.
Email: petelguzov.a@nczd.ru
ORCID iD: 0000-0002-6686-4042

Traumatologist-Orthopedist

Russian Federation, Moscow

References

  1. Михайловский М.В. Основные принципы хирургической коррекции идиопатического сколиоза. Хирургия позвоночника. 2005;(1):56-62 [Mikhailovsky MV. General principles of idiopathic scoliosis surgical correction. Russian Journal of Spine Surgery. 2005;(1):056-62 (in Russian)]. doi: 10.14531/ss2005.1.56-62
  2. Kino K, Fujiwara K, Fujishiro T, et al. Health-related quality of life, including marital and reproductive status, of middle-aged Japanese women with posterior spinal fusion using Cotrel-Dubousset instrumentation for adolescent idiopathic scoliosis: Longer than 22-year follow-up. J Orthop Sci. 2020;25(5):820-4.
  3. Suk SI, Lee CK, Kim WJ, et al. Segmental pedicle screw fixation in the treatment of thoracic idiopathic scoliosis. Spine. 1995;20:1399-405.
  4. Tambe AD, Panikkar SJ, Millner PA, Tsirikos AI. Current concepts in the surgical management of adolescent idiopathic scoliosis. Bone Jt. J. 2018;100B:415-24.
  5. Tsirikos AI, McMillan TE. All Pedicle Screw versus Hybrid Hook-Screw Instrumentation in the Treatment of Thoracic Adolescent Idiopathic Scoliosis (AIS): A Prospective Comparative Cohort Study. Healthcare (Basel, Switzerland). 2022;10(8):1455. doi: 10.3390/healthcare10081455
  6. Kim YJ, Lenke LG, Kim J, et al. Comparative analysis of pedicle screw versus hybrid instrumentation in posterior spinal fusion of adolescent idiopathic scoliosis. Spine. 2006;31:291-8.
  7. Kuklo TR, Potter BK, Polly DW, et al. Monoaxial versus multiaxial thoracic screws in the correction of adolescent idiopathic scoliosis. Spine. 2005;30:2113-20.
  8. Виссарионов С.В., Дроздецкий А.П. Тактика хирургического лечения детей с идиопатическим сколиозом грудной локализации. Хирургия позвоночника. 2010;(4):25-9 [Vissarionov SV, Drozdetsky AP. Surgical approach to the treatmentof children with thoracicidiopathic scoliosis. Russian Journal of Spine Surgery. 2010;(4):25-9 (in Russian)]. doi: 10.14531/ss2010.4.25-29
  9. Колесов С.В., Колян В.С., Казьмин А.И., Гулаев Е.В. Сравнительный анализ эффективности комбинированного метода введения транспедикулярных винтов с методикой free-hand у пациентов с идиопатическим сколиозом. Хирургия позвоночника. 2022;19(2):12-8 [Kolesov SV, Kolyan VS, Kazmin AI, Gulaev EV. Comparative analysis of the effectiveness of the combined method of inserting pedicle screws with the free-hand technique in patients with idiopathic scoliosis. Russian Journal of Spine Surgery. 2022;19(2):12-8 (in Russian)].
  10. Croci DM, Nguyen S, Streitmatter SW, et al. O-Arm Accuracy and Radiation Exposure in Adult Deformity Surgery. World Neurosurg. 2023;171:e440-6.
  11. Rao G, Brodke DS, Rondina M, Dailey AT. Comparison of computerized tomography and direct visualization in thoracic pedicle screw placement. J Neurosurg. 2002;97(2 Suppl):223-6.
  12. Kwan MK, Chiu CK, Gani S, Wei C. Accuracy and Safety of Pedicle Screw Placement in Adolescent Idiopathic Scoliosis Patients: A Review of 2020 Screws Using Computed Tomography Assessment. Spine. 2017;42(5):326-35.
  13. Librianto D, Saleh I, Fachrisal I, et al. Breach Rate Analysis of Pedicle Screw Instrumentation using Free-Hand Technique in the Surgical Correction of Adolescent Idiopathic Scoliosis. J Orthop Case Rep. 2021;11(1):38-44. doi: 10.13107/jocr.2021.v11.i01.1956
  14. Modi HN, Suh SW, Fernandez H, et al. Accuracy and safety of pedicle screw placement in neuromuscular scoliosis with free-hand technique. Eur Spine J. 2008;17(12):1686-96. doi: 10.1007/s00586-008-0795-6
  15. Baky FJ, Milbrandt T, Echternacht S, et al. Intraoperative Computed Tomography-Guided Navigation for Pediatric Spine Patients Reduced Return to Operating Room for Screw Malposition Compared With Freehand/Fluoroscopic Techniques. Spine Deform. 2019;7(4):577-81. doi: 10.1016/j.jspd.2018.11.012
  16. Van de Kelft E, Costa F, Van der Planken D, Schils F. A prospective multicenter registry on the accuracy of pedicle screw placement in the thoracic, lumbar, and sacral levels with the use of the O-arm imaging system and StealthStation Navigation. Spine (Phila Pa 1976). 2012;37(25):E1580-7. doi: 10.1097/BRS.0b013e318271b1fa
  17. O’Brien MF. Sacropelvic fixation in spinal deformity. In: DeWald R.L, ed. Spinal Deformities: The Comprehensive Text. Thieme; New York, 2003.
  18. Shillingford JN, Laratta JL, Tan LA, et al. The Free-Hand Technique for S2-Alar-Iliac Screw Placement: A Safe and Effective Method for Sacropelvic Fixation in Adult Spinal Deformity. J Bone Joint Surg Am. 2018;100(4):334-42. doi: 10.2106/JBJS.17.00052
  19. Lee MC. S2-Alar-Iliac Screw Placement: Who Needs Imaging?: Commentary on an article by Jamal N. Shillingford, MD, et al. The Free-Hand Technique for S2-Alar-Iliac Screw Placement. A Safe and Effective Method for Sacropelvic Fixation in Adult Spinal Deformity. J Bone Joint Surg Am. 2018;100(4):e25. doi: 10.2106/JBJS.17.01164
  20. Ray WZ, Ravindra VM, Schmidt MH, Dailey AT. Stereotactic navigation with the O-arm for placement of S-2 alar iliac screws in pelvic lumbar fixation. J Neurosurg Spine. 2013;18(5):490-5. doi: 10.3171/2013.2.SPINE12813
  21. Merloz P, Tonetti J, Pittet L, et al. Pedicle screw placement using image guided techniques. Clin Orthop Relat Res. 1998;(354):39-48. doi: 10.1097/00003086-199809000-00006
  22. Diab M, Smith AR, Kuklo TR; Spinal Deformity Study Group. Neural complications in the surgical treatment of adolescent idiopathic scoliosis. Spine (Phila Pa 1976). 2007;32(24):2759-63. doi: 10.1097/BRS.0b013e31815a5970
  23. Delecrin J, Bernard JM, Pereon Y. Various mechanisms of spinal cord injury during scoliosis surgery. Neurological Complications of Spinal Surgery. Proceedings of the 11th GICD Congress. Arcachon, France, 1994.
  24. Михайловский М.В., Фомичев Н.Г. Хирургия деформаций позвоночника. 2-е изд, испр. и доп. Новосибирск: Redactio, 2011 [Mikhailovskii MV, Fomichev NG. Khirurgiia deformatsii pozvonochnika. 2-e izd, ispr. i dop. Novosibirsk: Redactio, 2011 (in Russian)].
  25. Floccari LV, Larson AN, Crawford CH, et al. Which Malpositioned Pedicle Screws Should Be Revised? J Pediatr Orthop. 2018;38(2):110-5. doi: 10.1097/BPO.0000000000000753
  26. Kwan MK, Loh KW, Chung WH, et al. Perioperative outcome and complications following single-staged Posterior Spinal Fusion (PSF) using pedicle screw instrumentation in Adolescent Idiopathic Scoliosis (AIS): a review of 1057 cases from a single centre. BMC musculoskeletal disorders. 2021;22(1):413.
  27. Nash CL, Lorig RA, Schatzinger LA, Brown RH. Spinal cord monitoring during operative treatment of the spine. Clin Orthop Relat Res. 1977;(126):100-5.
  28. Колесов С.В. Хирургия деформаций позвоночника. Под ред. акад. РАН и РАМН С.П. Миронова. М.: Авторская Академия, 2014 [Kolesov SV. Khirurgiia deformatsii pozvonochnika. Pod red. akad. RAN i RAMN SP Mironova. Moscow: Avtorskaia Akademiia, 2014 (in Russian)].
  29. Pastorelli F, Di Silvestre M, Plasmati R, et al. The prevention of neural complications in the surgical treatment of scoliosis: the role of the neurophysiological intraoperative monitoring. Eur Spine J. 2011;20 Suppl 1(Suppl 1):S105-14.
  30. Khit MA, Kolesov SV, Kolbovskiy DA, Morozova NS. The role of the neurophysiological intraoperative monitoring to prevention of postoperative neurological complication in the surgical treatment of scoliosis. Neuromuscular Diseases. 2015.
  31. Buckwalter JA, Yaszay B, Ilgenfritz RM, et al. Analysis of Intraoperative Neuromonitoring Events During Spinal Corrective Surgery for Idiopathic Scoliosis. Spine Deform. 2013;1(6):434-8. doi: 10.1016/j.jspd.2013.09.001
  32. Oertel MF, Hobart J, Stein M, et al. Clinical and methodological precision of spinal navigation assisted by 3D intraoperative O-arm radiographic imaging. J Neurosurg Spine. 2011;14:532-6. doi: 10.3171/2010.10.SPINE091032
  33. Kudo H, Wada K, Kumagai G, et al. Accuracy of pedicle screw placement by fluoroscopy, a three-dimensional printed model, local electrical conductivity measurement device, and intraoperative computed tomography navigation in scoliosis patients. Eur J Orthop Surg Traumatol. 2021;31(3):563-9. doi: 10.1007/s00590-020-02803-2
  34. Jin M, Liu Z, Liu X, et al. Does intraoperative navigation improve the accuracy of pedicle screw placement in the apical region of dystrophic scoliosis secondary to neurofibromatosis type I: comparison between O-arm navigation and free-hand technique. Eur Spine J. 2016;25(6):1729-37. doi: 10.1007/s00586-015-4012-0
  35. Feng W, Wang W, Chen S, et al. O-arm navigation versus C-arm guidance for pedicle screw placement in spine surgery: a systematic review and meta-analysis. Int Orthop. 2020;44(5):919-26. doi: 10.1007/s00264-019-04470-3

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