Spinal surgeries are a common procedure, yet almost 50% of them are performed wrong. Many surgeons will do the surgery on the wrong level of the spine. The reason why this is so common is because there are many things that can make it problematic to determine the site of the procedure. Surgeries on the thoracic spine can be difficult in the case of obesity, osteoporosis, and variations in the amount of rib-bearing vertebra. Sometimes the distance between spinal landmarks can vary and cause problems. To avoid these problems in the future, a new technique to this surgery is being used.
The New Technique
The new way to perform this surgery is to use percutaneous placement of a screw into a thoracic vertebra in order to pinpoint the appropriate location. This screw is inserted by way of a computed tomography or CT guidance. It is a simple operation and can even be an outpatient procedure. During the operation, radiographs or CT scans can be used to determine the operative level. Doctors use fluoroscopy in order to make the screw visible.
Testing the Accuracy
The results of 26 patients who had the fiducially screw implant were studied. The location of the screw was determined using fluoroscopy and percutaneous needles. During these surgeries, none of them were subject to wrong-level procedure. The amount of time it took to find the location of the screw using fluoroscopic was much shorter. Even though a CT scan has to be used to implant the screw, the amount of radiation exposure is much less during the procedure. Costs are also decreased because the shortened operating time offsets the cost of implanting the screw.
After all the procedures were done and the data was studied, it was concluded that fiducial screws are accurate and efficient for identifying the surgical level in a thoracic spine surgery. This screw provides surgeons with a map to find the correct level in the spine. It prevents surgeons from having to guess at where they are during an operation or count the number of vertebrae. This is especially beneficial in patients that have variations in their spine such as an extra rib. Surgeons and patients can now breathe easier during minimally invasive surgeries or large scale operations that there will not be a problem with operating on the wrong level. This new technique will save money and benefit patients health in future surgeries.
This is a guest article contributed by Dr. Fayaz who is a licensed neurosurgeon and has been in practice for twenty years. Dr. Fayaz specializes in General neurosurgery, brain tumors, lumbar spine, thoracic spine, and spinal disorders.