RT Journal Article
SR Electronic
T1 Feasibility of Endoscopic Inspection of Pedicle Wall Integrity in a Live Surgery Model
JF International Journal of Spine Surgery
JO Int J Spine Surg
FD International Society for the Advancement of Spine Surgery
SP 241
OP 249
DO 10.14444/5030
VO 12
IS 2
A1 RADCLIFF, KRISTEN
A1 SMITH, HARVEY
A1 KALANTAR, BOBBY
A1 ISAACS, ROBERT
A1 WOODS, BARRETT
A1 VACCARO, ALEXANDER R.
A1 BRANNON, JAMES
YR 2018
UL https://www.ijssurgery.com/content/12/2/241.abstract
AB Background: Perforations of the pedicle wall during cannulation can occur with experienced surgeons. Direct endoscopic visualization has not been used to inspect pedicles previously due to bone bleeding obscuring the camera visualization. The hypothesis of this study was that endoscopic visualization of pedicle wall integrity was technically feasible and would enable identification of clinically significant pedicle breaches. Methods: A live porcine model was used. Eight lumbar pedicles were cannulated. Clinically significant breaches were created. An endoscope was introduced and was used to inspect the pedicles.Results: All lumbar pedicles were endoscopically visible at a systolic pressure of 100 mm Hg. Clinically relevant anatomic structures and iatrogenic pathology, such as medial, lateral, and anterior breaches, were identified. There were no untoward events resulting from endoscopic inspection of the pedicle endosteal canal.Conclusions: Endoscopic inspection of lumbar pedicles was safe and effective. The findings on endoscopic inspection corresponded with the ball-tip probe palpation techniques. Additional techniques, such as selection between 2 tracts, was possible with the endoscopic technique.