DensiProbe Spine: an intraoperative measurement of bone quality in spinal instrumentation. A clinical feasibility study

Popp, Albrecht W.; Schwyn, Ronald; Schiuma, Damiano; Keel, Marius; Lippuner, Kurt; Benneker, Lorin Michael (2013). DensiProbe Spine: an intraoperative measurement of bone quality in spinal instrumentation. A clinical feasibility study. Spine Journal, 13(10), pp. 1223-1229. Elsevier 10.1016/j.spinee.2013.06.067

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BACKGROUND CONTEXT A new device, DensiProbe, has been developed to provide surgeons with intraoperative information about bone strength by measuring the peak breakaway torque. In cases of low bone quality, the treatment can be adapted to the patient's condition, for example, by improving screw-anchorage with augmentation techniques. PURPOSE The objective of this study was to investigate the feasibility of DensiProbe Spine in patients undergoing transpedicular fixation. STUDY DESIGN Prospective feasibility study on consecutive patients. PATIENT SAMPLE Fourteen women and 16 men were included in this study. OUTCOME MEASURES Local and general bone quality. METHODS These consecutive patients scheduled for transpedicular fixation were evaluated for bone mineral density (BMD), which was measured globally by dual-energy X-ray absorptiometry and locally via biopsies using quantitative microcomputed tomography. The breakaway torque force within the vertebral body was assessed intraoperatively via the transpedicular approach with the DensiProbe Spine. The results were correlated with the areal BMD at the lumbar spine and the local volumetric BMD (vBMD) and a subjective impression of bone strength. The feasibility of the method was evaluated, and the clinical and radiological performance was evaluated over a 1-year follow-up. This study was funded by an AO Spine research grant; DensiProbe was developed at the AO Research Institute Davos, Switzerland; the AO Foundation is owner of the intellectual property rights. RESULTS In 30 patients, 69 vertebral levels were examined. The breakaway torque consistently correlated with an experienced surgeon's quantified impression of resistance as well as with vBMD of the same vertebra. Beyond a marginal prolongation of surgery time, no adverse events related to the usage of the device were observed. CONCLUSIONS The intraoperative transpedicular measurement of the peak breakaway torque was technically feasible, safe, and reliably predictive of local vBMD during dorsal spinal instrumentations in a clinical setting. Larger studies are needed to define specific thresholds that indicate a need for the augmentation or instrumentation of additional levels.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Orthopaedic, Plastic and Hand Surgery (DOPH) > Clinic of Osteoporosis
04 Faculty of Medicine > Department of Orthopaedic, Plastic and Hand Surgery (DOPH) > Clinic of Orthopaedic Surgery

UniBE Contributor:

Popp, Albrecht; Keel, Marius; Lippuner, Kurt and Benneker, Lorin Michael

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1529-9430, 1878-1632

Publisher:

Elsevier

Language:

English

Submitter:

Stephanie Schmutz

Date Deposited:

31 Mar 2014 11:11

Last Modified:

31 Mar 2014 11:14

Publisher DOI:

10.1016/j.spinee.2013.06.067

PubMed ID:

23999229

Uncontrolled Keywords:

Bone mineral density, Local bone strength, Pedicle screw failure, Spinal fixation

URI:

https://boris.unibe.ch/id/eprint/42661

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