Pedicle Screw Positioning With MySpine vs Free Hand Technique

Medacta International SA29 enrolled

Overview

Randomized clinical study in order to evaluate the accuracy of pedicle screw positioning during spine surgery performed with MySpine patient match positioning guide or Free hand technique.

The proposed study seeks to assess the intraoperative accuracy of the Medacta patient-specific MySpine® pedicle screws placement guides in comparison to free-hand technique. A pre-operative CT scan of the spine is obtained to create a 3-dimensional model of the patient's spine for the MySpine patient group. This model is then used to preoperatively plan the patient's surgery implantation itself, with the same goals of both free-hand and computer assisted techniques. The theoretical advantage of this technique is accurate implant placement without the added surgical time and complexity of the procedure, with lower radiation exposure thanks to less steps of fluoroscopy checks. The hypothesis for the present study is that the MySpine® technique can place pedicle screws more accurately in comparison to free-hand technique. The accuracy of the final implant position with respect to the pre-operative planning will be evaluated through CT post-op analysis.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

NONE

Enrollment

Conditions

Spinal Deformity

Interventions

patient specific pedicle screw positioning guidePROCEDURE

Free hand technique pedicle screw positioningPROCEDURE

MUST pedicle screwDEVICE

Eligibility

Sex: ALLMin age: 12 Years

Medical Language ↔ Plain English

Inclusion Criteria: * Patients older than 12 years * patients suffering from coronal or sagittal spinal deformities that will undergo a surgical treatment with a posterior approach and pedicle screws placement * Patients suitable to undergo spinal stabilization (according to the label indication/contraindications) * Patients who are willing and able to provide written informed consent for participation in the study. Written informed consent must be obtained when indication to surgery is confirmed. Exclusion Criteria: * Patient with congenital spinal deformity (emeverebre, vertebra wedge, vertebrate butterfly, congenital bar, vertebra block) * Patients with a previous fusion of the spine in the region where screws will be inserted * Patients with any allergy to the device implanted * Patients who will be not able to provide their written consent to the study participation * Patients who are incapable of understanding and wanting

Outcomes

Primary Outcomes

Accuracy of Pedicle Screw Positioning

Pedicle screw accuracy is defined as having the entire screw contained within the cortices of each respective pedicle.

Time frame: 1 week after surgery

Secondary Outcomes

Radiological Evaluation of Pedicle Screw Malposition

A CT will be performed before discharge to evaluate the severity of pedicle screws malposition according to Gertzbein in grades 0, A, B or C, with grades 0 or A considered as "safe area.". Level 0 (perfect corrected positioning of the screw), level A (0-2 mm of violation), level B (2-4 mm of violation), level C (˃4mm of violation). The better outcomes correspond to level 0 and the worst to level C.

Time frame: 1 weeks after surgery

Occurrence of Malposition Side

Evaluation of malposition on the medial or lateral side

Time frame: 1 weeks after surgery

Incidence of Adverse Event

Occurrence of intra-operative complications reporting

Time frame: intraoperatively, up to 1 week after surgery

Data from ClinicalTrials.gov

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