Joseph Albano, DO, MBA PGY 3 Plainview Hospital, Northwell Health - - PowerPoint PPT Presentation

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Dec 04, 2023 24 likes •169 views

Joseph Albano, DO, MBA PGY 3 Plainview Hospital, Northwell Health Disclosures No Disclosures Background Most spine surgery performed without preoperative pedicle measurements Some literature looking at individual races 1,2,3,4

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Joseph Albano, DO, MBA PGY 3 Plainview Hospital, Northwell Health

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Disclosures

 No Disclosures

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Background

 Most spine surgery performed without preoperative

pedicle measurements

 Some literature looking at individual races 1,2,3,4  Unclear in literature whether inter-race differences exist  Economic Impact 5

 Pseudoarthrosis - $76,695  Instrumentation Failure - $66,838  Revision Spine Surgery - $26,592 - $86,673

Tse MS, Chan CH, Wong KK, Wong WC. Quantitative Anatomy of C7 Vertebra in Southern Chinese for Insertion of Lateral Mass Screws and Pedicle

Screws. Asian Spine J. 2016 Aug;10(4):705-10.1

Yusof MI, Ming LK, Abdullah MS, Yusof AH. Computerized tomographic measurement of the cervical pedicles diameter in a Malaysian population and the feasibility for transpedicular fixation. Spine (Phila Pa 1976). 2006 Apr 15;31(8).2 Christodoulou AG, Apostolou T, Ploumis A, Terzidis I, Hantzokos I, Pournaras. J. Pedicle dimensions of the thoracic and lumbar vertebrae in the Greek population. Clin Anat. 2005 Sep;18(6):404-8.4 Singel TC, Patel MM, Gohil DV. A study of width and height of lumbar pedicles in Saurashtra Region. J. Anat. Soc. India. 53 (1) 4-9 (2004).4 Yeramaneni S, Robinson C, Hostin R. Impact of spine surgery complications on costs associated with management of adult spinal deformity. Current Reviews in Musculoskeletal Medicine. 5

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Inclusion Criteria

 CT Abdomen and Pelvis  July 1-July 14 2016  Must have race and age

listed in GE PACS

Exclusion Criteria

 Previous lumbar

laminectomy

 Previous instrumented

spinal fusion

 CT Lumbar Spine  Incomplete Visualization of

Pedicles

 Transitional Vertebra

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 Retrospective review CT Abdomen/Pelvis  506 patients  5060 Pedicles

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Strengths

 Large, multicenter study  Large sample size  Diverse native population  Single observer confirmed

by senior surgeon

 No spine related pathology

Limitations

 Patient position/cut size

not standardized

 Race not confirmed by

genetics

 ‘Other’ category not better

defined

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Conclusions

 Smallest pedicle diameters in Asian Race  Largest variability among the Black race  Careful preoperative measurements necessary  Standard Perioperative Xray not adequate to

maximize success

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