Figure 1 - available via license: Creative Commons Attribution 4.0 International
Content may be subject to copyright.
Patient is a 15 year-old female with Marfan syndrome with scoliosis. A and B, Standing preoperative anteroposterior and lateral radiographs. C and D, Standing anteroposterior and lateral radiographs 4 days after operation. E, Magnetic resonance images, showing improper implant location. F and G, Standing anteroposterior and lateral radiographs 4 days after reoperation.
Source publication
No recent studies have analyzed the rates of or reasons for unanticipated revision surgery within 30 days of primary surgery in spinal deformity patients. Our aim was to examine the incidence, characteristics, reasons, and risk factors for unplanned revision surgery in spinal deformity patients treated at one institution. All patients with a diagno...
Similar publications
Study Design
Retrospective study.
Objective
There have been few reports of adjacent segment disease (ASD) after posterior lumbar interbody fusion (PLIF) with large numbers and long follow-up. The purpose of this study was to investigate (1) ASD incidence and time periods after primary PLIF, (2) repeat ASD incidence and time periods, and (3) ASD in...
Study design:
Retrospective case series.
Objectives:
Both the rate and complexity of spine surgeries in elderly patients has increased. This study reports the outcomes of multilevel spine fusion in elderly patients and provides evidence on the appropriateness of complex surgery in elderly patients.
Methods:
We identified 101 patients older tha...
The aim of this meta‑analysis was to analyze the results of one‑stage all‑posterior spinal fusion for severe adolescent idiopathic scoliosis (AIS). A systematic search of articles about one‑stage posterior spinal fusion for severe AIS was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta‑Analyses guidelines. Data...
Introduction:
The successful surgical treatment of paediatric spinal deformity relies on robust anchors to achieve correction. Uniaxial pedicle screws are designed with articulation between the screw head and screw shaft, thus reducing the risk of anchor failure whilst permitting corrective manoeuvres. The purpose of this study was to describe the...
Background
There is no study concerning safety and accuracy of pedicle screw placement in Marfan syndrome. The objective of this study is to investigate accuracy and safety of pedicle screw placement in scoliosis associated with Marfan syndrome. MethodsCT scanning was performed to analyze accuracy of pedicle screw placement. Pedicle perforations we...
Citations
... Our aim with this data is to establish which elective procedures are associated with high reoperation rates and identify areas in which improving protocols may improve Table 3 The most common reoperation CPT codes for the 10 CPT procedure codes with the highest reoperation rates patient outcomes and limit burdens on the healthcare system. Unplanned reoperation is a risk factor for hospital readmission, worsens clinical outcomes, provides the opportunity for additional complications, and increases medical costs for patients [19][20][21]. In our analysis, the 30-day reoperation rate for a belowknee amputation (CPT 27880) was 6.92% (Table 1). ...
Background
Although elective procedures have life-changing potential, all surgeries come with an inherent risk of reoperation. There is a gap in knowledge investigating the risk of reoperation across orthopaedics. We aimed to identify the elective orthopaedic procedures with the highest rate of unplanned reoperation and the reasons for these procedures having such high reoperation rates.
Methods
Patients in the NSQIP database were identified using CPT and ICD-10 codes. We isolated 612,815 orthopaedics procedures from 2018 to 2020 and identified the 10 CPT codes with the greatest rate of unplanned return to the operating room. For each index procedure, we identified the ICD-10 codes for the reoperation procedure and categorized them into infection, mechanical failure, fracture, wound disruption, hematoma or seroma, nerve pathology, other, and unspecified.
Results
Below knee amputation (BKA) (CPT 27880) had the highest reoperation rate of 6.92% (37 of 535 patients). Posterior-approach thoracic (5.86%) or cervical (4.14%) arthrodesis and cervical laminectomy (3.85%), revision total hip arthroplasty (5.23%), conversion to total hip arthroplasty (4.33%), and revision shoulder arthroplasty (4.22%) were among the remaining highest reoperation rates. The overall leading causes of reoperation were infection (30.1%), mechanical failure (21.1%), and hematoma or seroma (9.4%) for the 10 procedures with the highest reoperation rates.
Conclusions
This study successfully identified the elective orthopaedic procedures with the highest 30-day return to OR rates. These include BKA, posterior thoracic and cervical spinal arthrodesis, revision hip arthroplasty, revision total shoulder arthroplasty, and cervical laminectomy. With this data, we can identify areas across orthopaedics in which revising protocols may improve patient outcomes and limit the burden of reoperations on patients and the healthcare system. Future studies should focus on the long-term physical and financial impact that these reoperations may have on patients and hospital systems.
Level of clinical evidence
IV.
... However, unplanned revision surgery is an awfully miserable experience for those who received a spinal operation, especially when it occurs within 30 days after the primary surgery. Furthermore, it increases the burden on the medical system due to the longer hospitalization time [10,11]. In addition, the need for reoperation may lead to an increase in patients' medical expenses, a higher risk of sequelae, and even endanger the doctor-patient relationship [6]. ...
... In our study, the causes of unplanned reoperations included wound infection, neurologic deficit, improper screw placement, loosening of internal fixation, dysphagia, cerebrospinal fluid leakage, and posterior fossa epidural hematomas, which is consistent with previous research. Li et al. [11] reported reasons for reoperation, such as pulmonary complications, implant failure, neurologic deficit, infection, and others. Jain et al. [15], who studied pediatric spinal fusion surgery, indicated that wound infections and implantrelated complications could lead to reoperation. ...
Purpose
To investigate the incidences, causes, and risk factors for unplanned reoperation within 30 days of craniovertebral junction (CVJ) surgery.
Methods
From January 2002 to December 2018, a retrospective analysis of patients who underwent CVJ surgery at our institution was conducted. The demographics, history of the disease, medical diagnosis, approach and type of operation, surgery duration, blood loss, and complications were recorded. Patients were divided into the no-reoperation group and the unplanned reoperations group. Comparison between two groups in noted parameters was analyzed to identify the prevalence and risk factors of unplanned revision and a binary logistic regression was performed to confirm the risk factors.
Results
Of 2149 patients included, 34(1.58%) required unplanned reoperation after the initial surgery. The causes for unplanned reoperation contained wound infection, neurologic deficit, improper screw placement, internal fixation loosens, dysphagia, cerebrospinal fluid leakage, and posterior fossa epidural hematomas. No statistical difference was found in demographics between two groups (P > 0.05). The incidence of reoperation of OCF was significantly higher than that of posterior C1-2 fusion (P = 0.002). In terms of diagnosis, the reoperation rate of CVJ tumor patients was significantly higher than that of malformation patients, degenerative disease patients, trauma patients, and other patients (P = 0.043). The binary logistic regression confirmed that different disease, fusion segment (posterior) and surgery time were independent risk factors.
Conclusions
The unplanned reoperation rate of CVJ surgery was 1.58% and the major causes were implant-related failures and wound infection. Patients with posterior occipitocervical fusion or diagnosed with CVJ tumors had an increased risk of unplanned reoperation.
... Unplanned reoperations are not expected by surgeons and patients, which will bring physical and psychological pressure to patients, increase hospitalization costs, and put pressure on social resources [13]. Unplanned reoperations account for between 2 and 10% of all surgeries in most surgical areas [14][15][16][17]. Several studies examined the risk factors of unplanned reoperation for head and neck cancer surgery complications. ...
Background
Unplanned reoperation (UR) after radical surgery for oral cancer (OC) is a health threat for the patients. The aim of the study was to identify the incidence of and risk factors for unplanned reoperation following oral cancer radical surgery, and to explore a potential role for long-term survival.
Methods
The present study followed a retrospective study design. Univariate and multivariate analyses were used to identify risk factors for demographic and clinical characteristics of patients. Survival analysis was performed by the Kaplan–Meier method. The data was analyzed statistically between November and December 2021.
Results
The incidence of UR was 15.7%. The primary cause of UR was reconstructed flap complications. Multivariate logistic regression analyses revealed that diabetes, tumor size, type of reconstruction, and nodal metastasis were independent risk factors for UR. Patients undergoing UR had a longer hospitalization, more post-operative complications, and a higher mortality compared with the non-UR group. UR is negatively correlated with the cancer-specific survival rate of patients ( Log-rank test, P = 0.024 ).
Conclusion
Diabetes, tumor size, pedicled flap reconstruction and cervical nodal metastasis (N2) as independent risk factors for UR was discovered. UR was positively correlated with perioperative complications prolong hospital stay, and increased early mortality, but negatively correlated with the cancer-specific survival rate survival rate.
... It has been proposed that the preventable shunt revision rate could be a quality metric used for external comparison in the pediatric population. [23][24][25] In the adult population, the preventable unplanned shunt implantation return rate has also been proposed as a possible external comparison quality metric. [26] Reviewing the literature on UROR related to CSF diversion, Mukerji et al [13] and Roy et al [12] previously reported that shunt-related procedures accounted for 44% and 40.8% of all pediatric procedures at their study institutions, respectively. ...
The unplanned return to the operating room rate is a quality metric for assessing hospital performance. This study aimed to evaluate the cause, incidence, and time interval of unplanned returns in index neurosurgical procedures within 30 days of the initial surgery as an internal audit. We retrospectively analyzed neurosurgical procedures between January 2015, and December 2019, in a single regional hospital. The definition of an unplanned return to the operating room was a patient who underwent two operations within 30 days when the second procedure was not planned, staged, or related to the natural course of the disease.
A total of 4365 patients were identified in our analysis, of which 93 (2%) had an unplanned return to the operating room within 30 days of their initial surgery during admission. The most common reason for an unplanned return to the operating room for a cranial procedure was hemorrhage, followed by hydrocephalus and subdural effusion, which accounted for 49.5%(46/93), 12%(11/93), and 5.4%(5/93) of cases, respectively. In spinal procedures, the most common cause of return was a residual disc, followed by surgical site infection, which accounted for 5.4%(5/93) and 4.3%(4/93) of cases, respectively. The overall median time interval for unplanned returns to the operating room was 3 days (interquartile range, 1–9).
Lowering the rate of postoperative hemorrhage in cranial surgery and postoperative residual disc in spine surgery was crucial as an internal audit in a 5-year single institute follow-up. However, the unplanned reoperation rate is less helpful in benchmarking because of the heterogeneity of patients between hospitals.
... Rights reserved. [17]. Identifying risk factors for readmission are critical for developing evidence based surgical guidelines for this patient population. ...
Purpose
The purpose of this study was to utilize the National Readmission Database (NRD) to determine estimates for complication rates, 90-day readmission rates, and hospital costs associated with spinal fusion in pediatric patients with Marfan syndrome.
Methods
The 2012–2015 NRD databases were queried for all pediatric (< 19 years old) patients diagnosed with Marfan syndrome undergoing spinal fusion surgery. The primary outcome variables in this study were index admission complications and 90-day readmissions.
Results
A total of 249 patients with Marfan syndrome underwent spinal fusion surgery between 2012 and 2015 (mean age ± standard deviation at the time of surgery: 14 ± 2.0, 132 (53%) female). 25 (10.1%) were readmitted within 90 days of the index hospital discharge date. Overall, 59.7% of patients experienced at least one complication during the index admission. Unplanned 90-day readmission could be predicted by older age (odds ratio 2.3, 95% confidence interval 1.3–4.2, p = 0.006), Medicaid insurance status (56.0, 3.8–820.0, p = 0.003), and experiencing an inpatient medical complication (42.9, 4.6–398.7, p = 0.001). Patients were readmitted for wound dehiscence (8 patients, 3.2%), nervous system related complications (3 patients, 1.2%), and postoperative infectious related complications (4 patients, 1.6%).
Conclusion
This study is the first to demonstrate on a national level the complications and potential risk factors for 90-day hospital readmission for patients with Marfan syndrome undergoing spinal fusion. Patients with Marfan syndrome undergoing spinal fusion often present with multiple medical comorbidities that must be managed carefully perioperatively to reduce inpatient complications and early hospital readmissions.
... 1,2 In one of the larger studies to date, the rate of medical complications within 6 weeks of ASD surgery was found to be 26.8%. 3 Within 30 days of ASD surgery, the rate of unplanned return to the operating room is reportedly 2.8%, and 24% at 2-year follow-up. [4][5][6] Previous studies have identified advanced age, smoking, and osteoporosis as important contributors to risk for perioperative complications. 7,8 Surgical factors including fusion of greater than 13 levels, longer operative times, and blood loss are also associated with an increased risk for complications and unplanned reoperation and readmission. ...
Background:
Data on timing of complications are important for accurate quality assessments. We sought to better define pre- and postdischarge complications occurring within 90 days of adult spinal deformity (ASD) surgery and quantify the effect of multiple complications on recovery.
Methods:
We performed a review of 1040 patients who underwent ASD surgery (age: 46 ± 23; body mass index: 25 ± 7, American Society of Anesthesiologists [ASA] score: 2.5 ± 0.6, levels: 10 ± 4, revision: 9%, 3-column osteotomy: 13%). We assessed pre- and postdischarge complications and risk factors for isolated versus multiple complications, as well as the impact of multiple complications.
Results:
The 90-day complication rate was 17.7%. 85 patients (8.2%) developed a predischarge complication, most commonly ileus (12%), and pulmonary embolism (PE; 7.1%). The most common causes of predischarge unplanned reoperation were neurologic injury (12.9%) and surgical site drainage (8.2%). Predictors of a predischarge complication included smoking (odds ratio [OR]: 2.2, P = .02), higher ASA (OR: 1.8, P = .008), hypertension (HTN; OR: 2.0, P = .004), and iliac fixation (OR: 4.3, P < .001). Ninety-nine patients (9.5%) developed a postdischarge complication, most commonly infection (34%), instrumentation failure (13.4%), and proximal junctional failure (10.4%). Predictors of postdischarge complications included chronic obstructive pulmonary disease (OR: 3.6, P < .0001), congestive heart failure (OR: 4.4, P = .016), HTN (OR: 2.3, P < .0001), and multiple rod construct (OR: 1.8, P = .02). Patients who developed multiple complications (9.3%) had a longer length of stay, and increased risk for readmission and unplanned reoperation.
Conclusions:
Knowledge regarding timing of postoperative complications in relation to discharge may better inform quality improvement measures. PE and implant-related complications play a prominent role in perioperative complications and need for readmission, with several modifiable risk factors identified.
Level of evidence:
Level 3.
Clinical relevance:
Advances in surgical techniques and instrumentation have improved postoperative radiographic and clinical outcomes after ASD surgery. The rate of complications after complex ASD surgery remains high, both at early postoperative and long term follow-up. This study reviews complications within 90 days of surgery, with an assessment of patient and surgical risk factors. We found that modifiable risk factors for early complications after ASD surgery include COPD, and current smoking. The data presented in this study also provide surgeons with knowledge of the most common complications encountered after ASD surgery, to aid in preoperative patient discussion.
... 1,2,3,4 SSIs are hospital-acquired infections (HAIs), they contribute to substantial morbidity, and represent a common cause of unplanned reoperation. 5,6 Preoperative infection prevention strategies implemented in recent years have been shown to improve surgical outcomes and reduce costs after spine surgery. 7,8 Over a 30-year period , the overall infection rate after posterior spinal fusion in children with neuromuscular scoliosis was 10.3% at our institution. ...
Background: Spinal surgery in pediatric neuromuscular and syndromic (NMS) patients is complicated and associated with numerous perioperative adverse events, unplanned reoperations, and suboptimal outcomes. SSIs are hospital acquired infections (HAIs), and they contribute to substantial morbidity in this patient population. This quality initiative (QI) focused on the development of a patient centered interdisciplinary medical optimization clinic and implementation of a standardized care pathway for NMS spinal fusion patients. Methods: In late 2017, an interdisciplinary committee was formed with the purpose of creating a patient centered medical optimization clinic for surgical patients with neuromuscular and syndromic scoliosis. It was labeled, the Neuromuscular and Syndromic Spine Pathway (NSP) Clinic. All NSP patients had standardized pre-surgical assessment. The aims of the initiative were to 1) measure compliance to the implemented NSP clinical pathway by creating standardized order sets in the electronic medical record (EMR) (EPIC), 2) create a free patient mobile app to address the following: a. coordination of necessary pre-operative appointments/consults, and b. pre and post- operative education (video links, hospital tour, provider contact information, and 3) reduced HAI SSI in NMS spinal fusion patients with a target goal of zero. The committee retrospectively reviewed the prospectively collected data for all NMS spine SSIs from 1/1/2018 to 12/31/2019. All infections were reviewed using Root Cause Analysis (RCA) methodology. Infection rates were calculated using rolling 6 month averages. Intervention: A “pilot” group of patients were evaluated and medically optimized through the NSP clinic. The NSP patient’s SSI risk was calculated using the Risk Severity Scale (RSS) pre-operatively16. This was compared to the actual HAI SSI rate to determine if the SSI risk could be positively modified through pre-operative medical optimization. Results: From 1/2018 -12/2019, 160 NMS patients underwent spinal fusion. 29 (18%) of those were medically optimized in the NSP clinic. There were 13 M and 16 F patients. The average age was 12.8 years, pre-op cobb angle was 85.4°, the pre-operative kyphosis was 76.1°, and the average pre-operative BMI was 17.4. The average pre-operative SSI RSS was calculated to be 19.69%. 0/29 (0%) NSP patients developed a HAI SSI. (p = 0.015) Whereas, 9/131 (6.9%) NMS scoliosis fusion patients that were “not cleared” (NC) through the NSP clinic developed a HAI SSI. By utilizing RCA methodology, a common trend was observed. In 2018, 9/69 (13.0%) patients that were NC through the NSP clinic developed a HAI SSI. 7/9 (77.7%) of those infections were due to S. aureus species. This drove the implementation of the second initiative. Second Intervention: The goal of this initiative was to create and implement a S. aureus screening and decolonization program for NMS scoliosis patients undergoing spinal fusion surgery at our institution. The pre- surgical screening was accomplished by culture of the anterior nares, tracheostomy tube, and/or gastrostomy tube sites. A positive culture for either methicillin-sensitive S. aureus (MSSA) and methicillin-resistant S. aureus (MRSA) was followed by decolonization with nasal mupirocin (2x/day) and a daily CHG bath for five days prior to the surgical date. The protocol utilized rapid (Plan-Do-Check-Act) cycles with a goal to reduce the HAI SSI rate due to S. aureus species in NMS spinal fusion patients within 1 year. Results: 68 NMS spinal fusion patients were screened for S. aureus colonization in 2019. Of the 68 patients screened, 36.8% (25/68) tested positive for S. aureus colonization. The prevalence of MSSA was 30.9% (21/68), while the prevalence of MRSA was 5.88% (4/68). The majority (68%) of organisms were culture positive in the anterior nares, 16 % from the gastrostomy tube, and 16% in both nares and gastrostomy tube. The HAI SSI rates for spinal fusion NMS patients decreased to 0/72 (0%) in 2019 (p= 0.003). Conclusion: Patient centered interdisciplinary pre-operative medical optimization modified the SSI risk in this “pilot” group of NMS scoliosis patients. The NSP clinic cohort had a 20% predicted risk of developing a HAI SSI, and actual rate was 0%. In contrast, 6.9% of the NMS scoliosis fusion patients that were NC through the NSP clinic developed an HAI SSI. 77.7% of those infections were due to S. aureus species. This drove the S. aureus screening and decolonization initiative which decreased the HAI SSI rate to zero within one year’s time. As a result of these QIs, ALL NMS spinal fusion patients at our institution are screened for S. aureus colonization, and medically optimized through the NSP clinic.
... [79] These procedures can also negatively affect staff trust and self-confidence. [80] It is important to know risk factors for revision surgery as a guide for implementing preventative measures. ASD is the cause of revision surgery after spinal fusion. ...
Study Design: This was a systematic review of the literature and meta-analysis.
Objective: The objective of this study was to evaluate the current literature regarding the risk factors contributing to reoperation due to adjacent segment disease (ASD).
Summary of Background Data: ASD is a broad term referring to a variety of complications which might require reoperation. Revision spine surgery is known to be associated with poor clinical outcomes and high rate of complications. Unplanned reoperation has been suggested as a quality marker for the hospitals.
Materials and Methods: An electronic search was conducted using PubMed. A total of 2467 articles were reviewed. Of these, 55 studies met our inclusion criteria and included an aggregate of 1940 patients. Data were collected pertaining to risk factors including age, sex, fusion length, lumbar lordosis, body mass index, pelvic incidence, sacral slope, pelvis tilt, initial pathology, type of fusion procedure, floating versus sacral or pelvic fusion, presence of preoperative facet or disc degeneration at the junctional segment, and sagittal orientation of the facets at the junctional segment. Analysis of the data was performed using Comprehensive Meta-Analysis software (Biostat, Inc.).
Results: The overall pooled incidence rate of reoperation due to ASD from all included studies was 0.08 (confidence interval: 0.065–0.098). Meta-regression analysis demonstrated no significant interaction between age and reoperation rate (P = 0.48). A comparison of the event rates between males and females demonstrated no significant difference between male and female reoperation rates (P = 0.58). There was a significantly higher rate of ASD in patients with longer fusion constructs (P = 0.0001).
Conclusions: We found that 8% of patients in our included studies required reoperation due to ASD. Our analysis also revealed that longer fusion constructs correlated with a higher rate of subsequent revision surgery. Therefore, the surgeon should limit the number of fusion levels if possible to reduce the risk of future reoperation due to ASD.
Level of evidence: IV
... Estimated incidence rates in most surgical fields fall between 2% and 10% of all surgical procedures, making URs difficult to study on an institution by institution basis. [7][8][9][10] Database studies, which provide larger numbers of patients with more patient and institutional diversity, are well suited to study infrequent outcomes, such as URs. Here, we used the American College of Surgeon's National Surgical Quality Improvement Program (ACS-NSQIP) database to identify the factors associated with URs among patients who had undergone head and neck surgical procedures. ...
Importance
Understanding the preoperative, intraoperative, and postoperative risk factors of reoperation is the optimal way to approach decreasing its incidence.
Objective
To identify risk factors of unplanned reoperation following major operations of the head and neck.
Design, Setting, and Participants
This retrospective cohort study queried the American College of Surgeons National Surgical Quality Improvement Program database and identified 2475 cases of major operations of the head and neck performed between 2005 and 2014. Specific operations analyzed were glossectomy, mandibulectomy, laryngectomy, and pharyngectomy. Univariate and multivariate analyses were performed to compare demographic and clinical characteristics of patients with or without unplanned reoperation. Data were analyzed between September and November 2017.
Main Outcomes and Measures
The primary outcome was incidence of unplanned reoperation in patients with major operations in the head and neck region. An additional aim was to assess the risk factors associated with an increased likelihood of reoperation.
Results
In total, 1941 patients were included in this study (1298 [66.9%] males), with most patients (961 [49.5%]) between 61 and 80 years of age. The overall unplanned reoperation rate within 30 days after the principal operative procedure was 14.2% (275 patients). The operative procedure with the highest reoperation rate was pharyngectomy (8 of 46 [17.4%]), followed by glossectomy (95 of 632 [15.0%]), laryngectomy (53 of 399 [13.3%]), and mandibulectomy (25 of 240 [10.4%]). Among the unplanned reoperation patients, 516 patients (76.8%) underwent reoperation during their initial hospital admission and 156 patients (23.2%) after readmission. The mean (SD) number of days from the principal operative procedure to unplanned reoperation was 8.5 (3.6) days for initial-admission reoperations and 16.0 (4.8) days for readmission reoperations. The most common unplanned reoperation procedures overall included repair, surgical exploration, and revision procedures on arteries and veins (47 of 2475 [1.9%]), incision procedures on the soft tissue of the neck and thorax (37 of 1941 [1.9%]), and incision and drainage procedures on the skin, subcutaneous, and accessory structures (21 of 1941 [1.1%]). Multivariate analysis results indicated that the independent risk factors for unplanned reoperation following a major cancer operation of the head or neck included black race (odds ratio [OR], 1.72; 95% CI, 1.09-2.74), disseminated cancer (OR, 1.85; 95% CI, 1.14-3.00), greater total operation time (OR, 2.05; 95% CI, 1.49-2.82), superficial (OR, 2.56; 95% CI, 1.55-4.24) or deep (OR, 4.83; 95% CI, 2.60-8.95) surgical site infection, wound dehiscence (OR, 8.36; 95% CI, 5.10-13.69), and ventilator dependence up to 48 hours after surgery (OR, 2.95; 95% CI, 1.79-4.87).
Conclusions and Relevance
The identification of a significant association of black race, disseminated cancer, total operation time, surgical site infection in either the superficial or deep spaces, wound dehiscence, or ventilator dependence for more than 48 hours after surgery with increased risk of reoperation in major head and neck surgery may guide the modification and adaptation of these risk factors to decrease the burden that unplanned reoperation places on patients, surgeons, and the health care system.
... Posterior spinal reconstruction with rods and pedicle screws has been widely used to corrects coliosis and other forms of degenerative spinal deformities [1][2][3][4][5]. Suk and colleagues first described the use of thoracic pedicle screws in the treatment of scoliosis in 1995, in which these screws permitted three-dimensional correction of deformity [6]. ...
Posterior spinal reconstruction with rods and pedicle screws has been widely used to corrects coliosis and other forms of degenerative spinal deformities. However, insertion of pedicle screwsis often clinically challenging, particularlyin patients with severe deformity. Bioelectrical impedance analysis is a technique that exploits the electrical properties of biological organs and tissues to indicate their compositions. Bioelectrical impedance measurement is non-invasive, simple, with adequate repeatability, and at a relatively low cost. In our study, we designed a bioelectrical impedance pedicle probe and use it to determine the bioelectrical impedance values in vitro and in vivo of different tissues relevant to pedicle screw insertion. We measured the bioelectrical impedance of different tissues relevant to pedicle screw placement in vitro and in vivo and explored the use of a prototype bioelectrical impedance pedicle probein guiding pedicle screw placement during spine surgery in animals. These data suggested that this novel bioelectrical impedance pedicle probe may be a new technique that has potential to offer accurate and safe placement of pedicle screws in spine surgery.
