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, 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:	05 Dec 2022 14:29
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