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Órgano Oficial de difusión científica de la Asociación Mexicana de Cirujanos de Columna A. C. y de la Sociedad Iberolatinoamericana de Columna. SILACO.

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2026, Number 3

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Cir Columna 2026; 4 (3)

Preoperative planning of pedicle screw placement using accessible tools: can high accuracy be achieved without high costs?

Quintanilla LR, Martínez GÓA, Reyes FPM, Silva RHNG, Alcántar DVA, González CD, Peña MVM

Language: Spanish
References: 15
Page: 215-221
PDF size: 653.56 Kb.


ABSTRACT

Introduction: thoracolumbar instrumentation requires high precision, which is difficult to ensure using anatomical references alone. Navigation systems based on intraoperative imaging are often limited by their high cost or lack of availability; therefore, digital preoperative planning has emerged as an accessible alternative. Objectives: to evaluate the clinical and radiographic accuracy of pedicle screw placement in thoracolumbar surgery by comparing the parameters established during digital preoperative planning with a dedicated application and the postoperative results. Material and methods: observational, retrospective study of 120 patients (810 screws). Preoperative planning was performed to determine the ideal diameter, length, and angulation using a digital application: 3D Slicer. Postoperative accuracy was assessed through computed tomography, and the correlation between planned and executed measurements was analyzed. Results: a total of 120 patients (810 screws) were included, of whom 81 were men (67.5%). The mean age was 47.1 ± 19.3 years. Spearman's correlation for diameter showed a coefficient of 0.855 (p < 0.001), while length demonstrated 0.789 (p < 0.001). Coronal angulation showed 0.966 (p < 0.001), and sagittal angulation showed 0.952 (p < 0.001). Conclusions: preoperative planning with a digital application enables transpedicular screw placement with an accuracy rate comparable to that of other navigation methods, while remaining safe and cost-effective.


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