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Master Thesis

Le taux d’irradiation peropératoire des ostéosynthèses thoraco-lombaires postérieures percutanées peut-il être réduit à l’aide d’un viseur pédiculaire à impédancemétrie ? Une étude prospective, randomisée

Abstract : STUDY DESIGN : Prospective, randomized study. OBJECTIVE : To report the results of using the PediGuard (SpineGuard®), a local electrical conductivity measurement device, to reduce intraoperative radiation exposure during percutaneous posterior spinal fusion. SUMMARY OF BACKGROUND DATA : Routine use of fluoroscopy is thought to reduce the risk of perforations but is associated with increased radiation. A new percutaneous pedicle-drilling device (PediGuard) which uses electrical conductivity differentiation at the tip for assessing bone versus soft tissue, has been developed to improve the safe positioning of pedicle screws. This device not only warns of an impending medial breach but also is the only device available to, in real time, nonradiographically detect a lateral breach. METHODS : Thirty-two patients with a diagnosis of thoracolumbar degenerative spine or traumatic spine who needed a posterior spinal fusion on one or two levels were enrolled. In a randomized fashion, the surgeon placed the pedicle screws either with a standard technique (manual probe) or the PediGuard, and used fluoroscopy for each drilling as a guidance assist as necessary. RESULTS : A total of 16 patients per group were included. The groups were comparable. The mean PDS at the end of the pedicular drilling and at the end of intervention were respectively 147.4 cGy.cm2 and 230.9 cGy.cm2 in the control group and 171.1 cGy.cm2 and 280.7 cGy.cm2 in the Pediguard group (p> 0.05). The placement of the screws was comparable in both groups. CONCLUSION : This study did not show a decrease in intraoperative irradiation rate with the use of PediGuard. It confirms the correlation of the rate of irradiation with the increase of the body mass index.
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Master Thesis
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Cyril Briand. Le taux d’irradiation peropératoire des ostéosynthèses thoraco-lombaires postérieures percutanées peut-il être réduit à l’aide d’un viseur pédiculaire à impédancemétrie ? Une étude prospective, randomisée. Sciences du Vivant [q-bio]. 2018. ⟨dumas-02145947⟩

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