MEASUREMENT OF VERTEBRAL CORTICAL INTEGRITY DURING PEDICLE EXPLORATION FOR INTRAPEDICULAR FIXATION

被引:20
作者
MYERS, BS
HASTY, CC
FLOBERG, DR
HOFFMAN, RD
LEONE, BJ
RICHARDSON, WJ
机构
[1] Department of Anesthesiology, Duke University, Durham, NC
关键词
Electrical; Impedance; Instrumentation; Pedicle; Probe; Spine;
D O I
10.1097/00007632-199501150-00003
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Study Design. This study determined the predictive ability of electrical impedance measurement in detecting cortical perforation in a porcine model of pedicular exploration. Objective. This study tested the hypothesis that a large decrease in electrical impedance would occur as a result of perforation of the vertebral cortex by the pedicle probe. Summary of Background Data. The resistivity of cortical bone has been reported to be 25 to 100 times greater than that of soft tissues. Methods. A total of 42 pedicles of the lumbar spines of six swine were explored using the instrumented pedicle probes. Results. Using a 1-mu Amp 30-Hz current source, measurement of electrical impedance predicted cortical rupture with a sensitivity, specificity, and accuracy of 95%. Maximum applied voltages of 2.8 mV did not result in myogenic stimulus. Conclusions. Electrical impedance measurement provides an accurate real-time measurement of cortical perforation. This technique is adapted readily for use with pedicular screws and screw taps. Further investigation to determine the clinical use of this technique is recommended.
引用
收藏
页码:144 / 148
页数:5
相关论文
共 18 条
[1]
Asher M.A., Strippgen W.E., Anthropometric studies of the human sacrum relating to dorsal transsacral implant designs, Clin Orthop, 203, pp. 58-62, (1986)
[2]
Boucher H.H., A method of spinal fusion, J Bone Joint Surg, 41, pp. 248-259, (1959)
[3]
Calancie B., Lebwohl N., Medsen P., Klose K.J., Intraoperative Evoked E., Monitoring in an animal model, a new technique for evaluating pedicle screw placement, Spine, 17, 10, pp. 1229-1235, (1992)
[4]
Geddes L.A., Baker L.E., The specific resistance of biological material-A compendium of data for the biomedical engineer and physiologist, Med Biol Engng, 5, pp. 271-293, (1967)
[5]
Krag M.H., Beynnon B.D., Pope M.H., Frymoyer J.W., Haugh L.D., Weaver D.L., An internal fixator for posterior application to short segments of the thoracic, lumbar, or lumbosacral spine: Design and testing, Clin Orthop, 203, pp. 75-98, (1986)
[6]
Krag M.H., Fredrickson B.E., Yuan H.A., Spinal instrumentation, The Lumbar Spine, pp. 916-940, (1990)
[7]
Krag M.H., Weaver D.L., Beynnon B.D., Haugh L.D., Morphometry of the thoracic and lumbar spine related to trans- pedicular screw placement for surgical spinal fixation, Spine, 13, pp. 27-32, (1988)
[8]
McAffee P.C., Farey I.D., Sutterlin C.E., Gurr K.R., Warden K.E., Cunningham B.W., Device-related osteoporosis with spinal instrumentation, Spine, 14, pp. 919-926, (1989)
[9]
McAffee P.C., Weiland D.J., Carlow J.J., Survivorship analysis of pedicle spinal instrumentation, Spine, 16, 8, pp. 422-432, (1991)
[10]
Pinto M.R., Complications of pedicle screw fixation. Spine, State of the Art Reviews, 6, 1, pp. 45-54, (1992)