Evaluation of the safety, radiographic and resident training results of thoracic pedicle screws placement using resection of the transverse process.

IF 1 4区医学 Q4 CLINICAL NEUROLOGY

British Journal of Neurosurgery Pub Date : 2025-04-01 Epub Date: 2023-05-11 DOI:10.1080/02688697.2023.2211174

Chia-En Wong, Po-Hsuan Lee, Chien-Min Chen, Chi-Chen Huang, Hao-Hsiang Hsu, Liang-Yi Chen, Chih-Yuan Huang, Liang-Chao Wang, Jung-Shun Lee

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引用次数: 0

Abstract

Objective: This study aimed at the evaluation and assessment of a simple method, the transverse process resection (TPR) technique, for freehand thoracic pedicle screw placement and the learning curve for trainee surgeons.

Methods: In the TPR technique, the tip of the thoracic transverse process (TP) is removed to create an entry point in the cancellous bone of the TP, and the thoracic pedicle is cannulated from the TP. We retrospectively evaluated the safety and radiographic results of the TPR technique and compared with that of conventional pedicle screws. The training performance of seven neurosurgical residents with TPR techniques were evaluated.

Results: Among 46 patients, a total of 322 thoracic screws were analyzed, including 178 screws placed using the TPR technique and 144 screws using the conventional straight-forward (SF) technique. TPR screws had greater medial angulations in all levels from T2 to T12 compared to SF screws (p < 0.001). The incidence of pedicle breach was lower in the TPR screws compared to SF screws (6.2% vs. 21.5%, p < 0.001), especially for screws placed by residents (6.7% vs. 29.6%, p < 0.001). Residents had improved performance following a cadaveric training course on the TPR technique (p = 0.001).

Conclusion: This study demonstrated the safety of the TPR technique for thoracic pedicle screw placement and its short learning curve for trainee surgeons.

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采用横突切除置入胸椎弓根螺钉的安全性、影像学和住院医师培训结果评估。

目的:本研究旨在评价和评估一种简单的方法——横突切除(TPR)技术，用于徒手置入胸椎弓根螺钉，并为实习外科医生提供学习曲线。方法:在TPR技术中，切除胸横突(TP)的尖端，在TP的松质骨中创建一个入口点，并从TP中插管胸椎弓根。我们回顾性评估TPR技术的安全性和影像学结果，并与传统椎弓根螺钉进行比较。对7名神经外科住院医师应用TPR技术的训练效果进行了评价。结果:46例患者共分析322枚胸椎螺钉，其中TPR技术置入178枚，SF技术置入144枚。与SF螺钉相比，TPR螺钉在T2至T12各节段的内侧成角更大(p p p = 0.001)。结论:本研究证明了TPR技术用于胸椎弓根螺钉置入的安全性，并且对实习外科医生来说学习曲线短。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

British Journal of Neurosurgery 医学-临床神经学

CiteScore

2.30

自引率

9.10%

发文量

139

审稿时长

3-8 weeks

期刊介绍： The British Journal of Neurosurgery is a leading international forum for debate in the field of neurosurgery, publishing original peer-reviewed articles of the highest quality, along with comment and correspondence on all topics of current interest to neurosurgeons worldwide. Coverage includes all aspects of case assessment and surgical practice, as well as wide-ranging research, with an emphasis on clinical rather than experimental material. Special emphasis is placed on postgraduate education with review articles on basic neurosciences and on the theory behind advances in techniques, investigation and clinical management. All papers are submitted to rigorous and independent peer-review, ensuring the journal’s wide citation and its appearance in the major abstracting and indexing services.