Universität zu Köln

Ahmadi, Sebastian A., Slotty, Philipp J., Schroeter, Catharina, Kroepil, Patric, Steiger, Hans-Jakob and Eicker, Sven O. (2014). Marking wire placement for improved accuracy in thoracic spinal surgery. Clin. Neurol. Neurosurg., 119. S. 100 - 106. AMSTERDAM: ELSEVIER SCIENCE BV. ISSN 1872-6968

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Abstract

Objective: To present an innovative approach that does not rely on intraoperative X-ray imaging for identifying thoracic target levels and critically appraise its value in reducing the risk of wrong-level surgery and radiation exposure. Methods: 96 patients admitted for surgery of the thoracic spine were prospectively enrolled, undergoing a total of 99 marking wire placements. Preoperatively a flexible marking wire derived from breast cancer surgery was inserted with computed tomography (CT) guidance at the site of interest - the wire was then used as an intraoperative guidance tool. Results: Wire placement was considered successful in 96 cases (97%). Most common pathologies were tumors (62.5%) and degenerative disorders (16.7%). Effective doses from CT imaging were significantly higher for wire placements in the upper third of the thoracic spine compared to the lower two thirds (p = 0.015). Radiation exposure to operating room personnel could be reduced by more than 90% in all non-instrumented cases. No adverse reactions were observed, one patient (1.04%) underwent surgical revision due to an epifascial empyema. No wires had to be removed due to lack of patient compliance or infection. Conclusions: This is a safe and practical approach to identify the level of interest in thoracic spinal surgery employing a marking wire. Its application merits consideration in any spinal case where X-ray localization could prove unsafe, particularly in cases lacking bony pathologies such as intradural tumors. (C) 2014 Elsevier B.V. All rights reserved.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Ahmadi, Sebastian A. UNSPECIFIED UNSPECIFIED UNSPECIFIED Slotty, Philipp J. UNSPECIFIED UNSPECIFIED UNSPECIFIED Schroeter, Catharina UNSPECIFIED UNSPECIFIED UNSPECIFIED Kroepil, Patric UNSPECIFIED UNSPECIFIED UNSPECIFIED Steiger, Hans-Jakob UNSPECIFIED UNSPECIFIED UNSPECIFIED Eicker, Sven O. UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-441512
DOI:	10.1016/j.clineuro.2014.01.025
Journal or Publication Title:	Clin. Neurol. Neurosurg.
Volume:	119
Page Range:	S. 100 - 106
Date:	2014
Publisher:	ELSEVIER SCIENCE BV
Place of Publication:	AMSTERDAM
ISSN:	1872-6968
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language WRONG-SITE SURGERY; C-ARM FLUOROSCOPY; INTRAOPERATIVE LOCALIZATION; TRANSITIONAL VERTEBRAE; PERCUTANEOUS PLACEMENT; PEDICLE SCREWS; LEVEL SURGERY; LUMBAR SPINE; PREVALENCE; RADIATION Multiple languages Clinical Neurology; Surgery Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/44151