Archives of Neuroscience Transpedicular Screw Insertion Guidance Device (TSIGD), A New Device for Spinal Transpedicular Screw Placement (A Pilot Study)

Background: Trans-pedicular screw placements have been an increasingly popular procedure in many neurosurgery and orthopedic departments. Any mistake at performing the technique could be followed by irreversible neurological deficit and damage of Para spinal vital structures as well as less stability for future fusion. Objectives: In this study we tried to show the benefits and capabilities of a new device, Transpedicular Screw Insertion Guidance Device (TSIGD) for best possible correct transpedicular screw placement. Patients and Methods: This study is a quasi-experimental study performed in 2010 in Isfahan at Al-Zahra General hospital. The study was based on the application of a new device, which is named Transpedicular Screw Insertion Guidance Device (TSIGD) that leads the neurosurgeon to find the Proper Pedicular Angle (PPA). Results: 10 patients were enrolled in this study, all of them with the waiver of consent. A total of 54 screws were assigned to evaluate the capability of the TSIGD for correct screw placement by PPA (Proper Pedicular angle) and SA (Screw Angle). Only 2 screws (5.5%) were identified as medial pedicular breach on postoperative CT scans without any neurological deficit. The mean Proper Pedicular Angle (PPA) was 26.15 (± 0.4) that was calculated based on axial CT scan performed before the operation and mean screw angel (SA) that was calculated based on axial CT scan after the operation was 25.79 (± 0.8), (P ≥ 0.05). Conclusions: Not only this method is less expensive for the patients but it also saves time during surgery in contrast to CT based surgery. Also, this device is useful for neurosurgical assistants and young surgeons to reduce misplacement of pedicular screw.