Experimental studies with the DSG Technology have demonstrated the added value of the PediGuard probe as a teaching tool for residents
In a study, 2.1% of the patients (11/531) presented after a TLIF procedure1 with worsening postoperative pain resulting from nerve root impingement by a pedicle screw. At least 50% of all pedicle screws had been placed by neurosurgical residents of varying experience. All implicated screws were removed and revised subsequently.
Reduction of the Learning Curve for Spine Surgery Residents
In a cadaveric study2, 5 residents were randomized and assigned 3 specimens each to prepare bilateral pedicles from T8 to L5 (60 pedicles per resident) using either PediGuard devices or the Free-Hand technique.
PediGuard probes decreased:
- The learning curve for placing pedicle screws
- The breach rate by 58% (19.7% in the non PediGuard vs 8.2% in the PediGuard group)
- Surgery time by 21% when placing pedicle screws
The PediGuard probe is very useful for resident training because they have the same sensation like a classic pedicle perforation and at the same time they gain experience of the sound. Even if they have no experience, in a few surgeries, they can put a pedicle screw in total safety.
Pr Richard Gouron
Professor of pediatric surgery
Amiens, France
Detection of Pedicle Breach with only 20 minutes of Didactic Training about the DSG Technology
Individuals of 3 levels of training (attending spine surgeon, orthopedic surgery resident and medical student) used the Cannulated PediGuard device to cannulate each levels between T2 and S13. The sensitivity of the Cannulated PediGuard probe to detect impending breach or breach of 4 mm or less has been evaluated:
- Average 90%
- Attending Spine Surgeons 96%
- Senior level resident 89%
- Medical Student 84%
References
1 – Floccari LV. J Pediatr Orthop. 2017 May 17.[Epub ahead of print]
2 – Sandhu F, Syed H et al. The Use of an Electrical Conductivity-Monitoring Device (ECMD) Shortens the Learning Curve for Accurate Placement of Pedicle Screws: A Cadaveric Study. Presented at the CNS 2014 and SRS 2015
3 – Guillen PT et al. Independent assessment of a new pedicle probe and its ability to detect pedicle breach: a cadaveric study. J Neurosurg Spine. 2014 Nov; 21(5):821-5.
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