Turkish Neurosurgery 2021 , Vol 31 , Num 4
A Novel Retractor for Reducing Operation Time and Radiation Exposure in Percutaneous Pedicle Screw Placement
Lei NIU1,Rui HE1,Liqun DUAN1,Wenzhi ZHANG1,Xu LI1,Haiping CAI1
1Department of Orthopedics, The First Affiliated Hospital of University of Science and Technology of China DOI : 10.5137/1019-5149.JTN.36033-21.3 AIM: To design a novel hand-held retractor in order to reduce both operation time and radiation exposure in percutaneous pedicle screw placement.

MATERIAL and METHODS: A total of 126 patients with single segment thoracolumbar vertebral fracture were surgically treated with percutaneous pedicle screws through our novel hand-held retractor technique (group A) or conventional fluoroscopic method (group B), the operation time and fluoroscopy shot times were compared, and the accuracy of screw placement were assessed.

RESULTS: There was no serious complications occurring during our study, such as infection, blood vessel injury, spinal cord or nerve root injury. We did not find any statistically difference between the two groups in corrected rate of regional Cobb?s angle or vertebral body height percentage (p>0.05), however, the mean operation time was found to be 75.9 ± 2.37 min in the novel handheld retractor method group and 94.2 ± 2.19 min in the conventional method group. The difference was statistically significant (p?0.001). Fluoroscopy shot times averaged 9.01 ± 0.41 in the novel hand-held retractor group versus 16.8 ± 0.56 in the conventional group (p<0.001), the novel hand-held retractor group had apparent advantages over the conventional method in postoperative improvement on visual analog scale (VAS) scores and Oswestry Disability Index (ODI) at 2 days, 3 months after operation and last follow-up (p<0.05). There was no statistical difference between group A and B in the radiographic results and screw position violation grade.

CONCLUSION: The novel hand-held method retractors have several advantages, including shorter operation time, less fluoroscopy shot times, and better postoperative improvement on visual analog scale (VAS) scores and Oswestry Disability Index (ODI). It provides a new alternative method for effective management of thoracolumbar fractures. Keywords : Percutaneous pedicle screw, Novel retractor, Surgery time, Fluoroscopy shot time, Thoracolumbar vertebral fracture

Corresponding author : Lei NIU, 179644522@qq.com