Turkish Neurosurgery
Usefulness and radiological evaluation of accuracy of innovative “Smart” hand technique for pedicle screw placement: an anatomical study
Ayhan Cömert1, İhsan Doğan2, Y. Şükrü Çağlar2
1Ankara University School of Medicine, Department of Anatomy, Ankara,
2Ankara University School of Medicine, Department of Neurosurgery, Ankara,
DOI: 10.5137/1019-5149.JTN.21391-17.1

Aim:The aim of this study is to use a smartphone application during pedicle screw placement navigation and examine the accuracy of this application on anatomical dry vertebrae model.Material and Methods:76 dry vertebrae were used for this study and pedicle entry points, projections of pedicle screw trajectory lines in lateral and superior aspect of vertebral body were identified and drawn for each vertebra bilaterally. In each position, all angulations were measured directly before the procedure manually. 152 pedicle screws were inserted as a simulation of screw placement with the guidance of angle-meter smart app. Accuracy of the method was tested according to the occurrence of bone penetration and angular deviation of the inserted screws was evaluated in computed tomography images.Results:Mean deviation of pedicle screws of 76 pedicle screws in right side in horizontal plane was measured 2.30°±1.78°; in sagittal plane 2.17°±1.57° and in left side in horizontal plane 3.01°±1.83°; in sagittal plane 2.38°±1.68°. No bone penetration was occurred during 152 pedicle screw placements. According to the t-test results, there were significant differences between two groups in craniocaudal direction of the right side pedicle screws and in craniocaudal direction of left side pedicle screws.Conclusion:The free smartphone application presented here as angle-meter can be interpreted as a safe digital device for spinal instrumentation procedures. As a prototype of future pedicle screw fixation systems, it should be improved in terms of its feasibility and compatibility with screw probes. This may lead to apply mobile digital angle meter in spinal procedure.

Corresponding author : Ayhan Cömert