A Sternum-Disk Distance Method to Identify the Skin Level for Approaching a Surgical Segment without Fluoroscopy Guidance during Anterior Cervical Discectomy And Fusion
Study DesignA retrospective review of prospectively collected data.PurposeTo introduce the sternum-disk distance (SDD) method for approaching the exact surgical level without C-arm guidance during anterior cervical discectomy and fusion (ACDF) surgery and to evaluate its accuracy and reliability.Ove...
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doaj-d2490fd98f5b42f4afb416d6119dd4252020-11-24T21:42:54ZengKorean Spine SocietyAsian Spine Journal1976-19021976-78462017-02-01111505610.4184/asj.2017.11.1.50245A Sternum-Disk Distance Method to Identify the Skin Level for Approaching a Surgical Segment without Fluoroscopy Guidance during Anterior Cervical Discectomy And FusionGun Woo Lee0Myun-Whan Ahn1Ji-Hoon Shin2Jae Woo Park3Jae-Hyung Uh4Jong-Ho Park5Ji-Hoon Lee6Dong-Wook Kim7Jin S. Yeom8Bo-Gun Suh9Department of Orthopaedic Surgery, Yeungnam University Hospital, Yeungnam University College of Medicine, Daegu, Korea.Department of Orthopaedic Surgery, Yeungnam University Hospital, Yeungnam University College of Medicine, Daegu, Korea.Department of Orthopaedic Surgery, Yeungnam University Hospital, Yeungnam University College of Medicine, Daegu, Korea.Department of Orthopaedic Surgery, Yeungnam University Hospital, Yeungnam University College of Medicine, Daegu, Korea.Spine Center and Department of Orthopaedic Surgery, Pohang Semyeng Christianty Hospital, Pohang, Korea.Spine Center and Department of Orthopaedic Surgery, Pohang Semyeng Christianty Hospital, Pohang, Korea.Spine Center and Department of Orthopaedic Surgery, Pohang Semyeng Christianty Hospital, Pohang, Korea.Spine Center and Department of Orthopaedic Surgery, Pohang Semyeng Christianty Hospital, Pohang, Korea.Spine Center and Department of Orthopaedic Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Sungnam, Korea.Spine Center and Department of Orthopaedic Surgery, Pohang Semyeng Christianty Hospital, Pohang, Korea.Study DesignA retrospective review of prospectively collected data.PurposeTo introduce the sternum-disk distance (SDD) method for approaching the exact surgical level without C-arm guidance during anterior cervical discectomy and fusion (ACDF) surgery and to evaluate its accuracy and reliability.Overview of LiteratureAlthough spine surgeons have tried to optimize methods for identifying the skin level for accessing the operative disk level without C-arm guidance during ACDF, success has rarely been reported.MethodsIn total, 103 patients who underwent single-level ACDF surgery with the SDD method were enrolled. The primary outcome measure was the accuracy of the SDD method. The secondary outcome measures were the mean SDD value at each cervical level from the cranial margin of the sternum in the neutral and extension positions of the cervical spine and the inter- and intra-observer reliability of the SDD outcome determined using repeated measurements by three orthopedic spine surgeons.ResultsThe SDD accuracy (primary outcome measure) was indicated in 99% of the patients (102/103). The mean SDD values in the neutral-position magnetic resonance imaging (MRI) were 108.8 mm at C3–C4, 85.3 mm at C4–C5, 64.4 mm at C5–C6, 44.3 mm at C6–C7, and 24.1 mm at C7–T1; and those in the extension-position MRI were 112.9 mm at C3–C4, 88.7 mm at C4–C5, 67.3 mm at C5–C6, 46.5 mm at C6–C7, and 24.3 mm at C7–T1. The Cohen kappa coefficient value for intra-observer reliability was 0.88 (excellent reliability), and the Fleiss kappa coefficient value for inter-observer reliability as reported by three surgeons was 0.89 (excellent reliability).ConclusionsBased on the results of the present study, we recommend performing ACDF surgery using the SDD method to determine the skin level for approaching the surgical cervical segment without fluoroscopic guidance.http://www.asianspinejournal.org/upload/pdf/asj-11-50.pdfSpinal fusionCervical vertebraeFluoroscopyMagnetic resonance imagingSternum-disk distance method |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Gun Woo Lee Myun-Whan Ahn Ji-Hoon Shin Jae Woo Park Jae-Hyung Uh Jong-Ho Park Ji-Hoon Lee Dong-Wook Kim Jin S. Yeom Bo-Gun Suh |
spellingShingle |
Gun Woo Lee Myun-Whan Ahn Ji-Hoon Shin Jae Woo Park Jae-Hyung Uh Jong-Ho Park Ji-Hoon Lee Dong-Wook Kim Jin S. Yeom Bo-Gun Suh A Sternum-Disk Distance Method to Identify the Skin Level for Approaching a Surgical Segment without Fluoroscopy Guidance during Anterior Cervical Discectomy And Fusion Asian Spine Journal Spinal fusion Cervical vertebrae Fluoroscopy Magnetic resonance imaging Sternum-disk distance method |
author_facet |
Gun Woo Lee Myun-Whan Ahn Ji-Hoon Shin Jae Woo Park Jae-Hyung Uh Jong-Ho Park Ji-Hoon Lee Dong-Wook Kim Jin S. Yeom Bo-Gun Suh |
author_sort |
Gun Woo Lee |
title |
A Sternum-Disk Distance Method to Identify the Skin Level for Approaching a Surgical Segment without Fluoroscopy Guidance during Anterior Cervical Discectomy And Fusion |
title_short |
A Sternum-Disk Distance Method to Identify the Skin Level for Approaching a Surgical Segment without Fluoroscopy Guidance during Anterior Cervical Discectomy And Fusion |
title_full |
A Sternum-Disk Distance Method to Identify the Skin Level for Approaching a Surgical Segment without Fluoroscopy Guidance during Anterior Cervical Discectomy And Fusion |
title_fullStr |
A Sternum-Disk Distance Method to Identify the Skin Level for Approaching a Surgical Segment without Fluoroscopy Guidance during Anterior Cervical Discectomy And Fusion |
title_full_unstemmed |
A Sternum-Disk Distance Method to Identify the Skin Level for Approaching a Surgical Segment without Fluoroscopy Guidance during Anterior Cervical Discectomy And Fusion |
title_sort |
sternum-disk distance method to identify the skin level for approaching a surgical segment without fluoroscopy guidance during anterior cervical discectomy and fusion |
publisher |
Korean Spine Society |
series |
Asian Spine Journal |
issn |
1976-1902 1976-7846 |
publishDate |
2017-02-01 |
description |
Study DesignA retrospective review of prospectively collected data.PurposeTo introduce the sternum-disk distance (SDD) method for approaching the exact surgical level without C-arm guidance during anterior cervical discectomy and fusion (ACDF) surgery and to evaluate its accuracy and reliability.Overview of LiteratureAlthough spine surgeons have tried to optimize methods for identifying the skin level for accessing the operative disk level without C-arm guidance during ACDF, success has rarely been reported.MethodsIn total, 103 patients who underwent single-level ACDF surgery with the SDD method were enrolled. The primary outcome measure was the accuracy of the SDD method. The secondary outcome measures were the mean SDD value at each cervical level from the cranial margin of the sternum in the neutral and extension positions of the cervical spine and the inter- and intra-observer reliability of the SDD outcome determined using repeated measurements by three orthopedic spine surgeons.ResultsThe SDD accuracy (primary outcome measure) was indicated in 99% of the patients (102/103). The mean SDD values in the neutral-position magnetic resonance imaging (MRI) were 108.8 mm at C3–C4, 85.3 mm at C4–C5, 64.4 mm at C5–C6, 44.3 mm at C6–C7, and 24.1 mm at C7–T1; and those in the extension-position MRI were 112.9 mm at C3–C4, 88.7 mm at C4–C5, 67.3 mm at C5–C6, 46.5 mm at C6–C7, and 24.3 mm at C7–T1. The Cohen kappa coefficient value for intra-observer reliability was 0.88 (excellent reliability), and the Fleiss kappa coefficient value for inter-observer reliability as reported by three surgeons was 0.89 (excellent reliability).ConclusionsBased on the results of the present study, we recommend performing ACDF surgery using the SDD method to determine the skin level for approaching the surgical cervical segment without fluoroscopic guidance. |
topic |
Spinal fusion Cervical vertebrae Fluoroscopy Magnetic resonance imaging Sternum-disk distance method |
url |
http://www.asianspinejournal.org/upload/pdf/asj-11-50.pdf |
work_keys_str_mv |
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