Department of Biomedical and Neuromotor Science-DIBINEM, 1St Orthopaedic and Traumatologic Clinic, IRCCS Istituto Ortopedico Rizzoli, University of Bologna, Bologna, Italy.
Musculoskelet Surg. 2021 Aug;105(2):117-123. doi: 10.1007/s12306-021-00714-x. Epub 2021 May 29.
Pedicle screws are the gold standard in spine surgery, allowing a solid tricolumnar fixation which is unmatched by hooks and wires. The freehand technique is the most widely adopted for pedicle screws placing. While freehand technique has been classically performed with manual tools, there has been a recent trend toward the use of power tools. The aim of this review is to summarize and expose potential risks and advantages of power pedicle screws placing. The literature showed that the use of power tools offers an acceptable safety profile, comparable to manual technique. With an adequate training, the power technique may speed up the screw placing, reduce the fluoroscopy time and the physical stress to the spine surgeon. Regarding differences in pull-out strength between power and manual techniques, the literature is still uncertain and inconsistent, both in clinical and preclinical studies. The choice between the use of power and manual freehand pedicle screws placing is still based on the surgeon's own preference.
椎弓根螺钉是脊柱外科的金标准，可实现坚固的三柱固定，这是钩和线无法比拟的。徒手技术是最广泛应用于椎弓根螺钉放置的方法。虽然徒手技术通常使用手动工具进行，但最近有一种使用动力工具的趋势。本综述的目的是总结和揭示使用动力椎弓根螺钉的潜在风险和优势。文献表明，使用动力工具具有可接受的安全性，与手动技术相当。经过适当的培训，动力技术可以加快螺钉的放置速度，减少透视时间，并减轻脊柱外科医生的身体压力。至于动力和手动技术之间的拔出强度差异，文献在临床和临床前研究中仍然存在不确定性和不一致性。在使用动力和手动徒手椎弓根螺钉放置之间的选择仍然取决于外科医生的个人喜好。
