Use of PediGuard® in MIS procedures

The frequency of minimally invasive procedures in spine surgery has increased significantly over the past 5 years. These procedures present numerous benefits, such as reduced muscular trauma and blood loss, as well as decreased surgery time and postoperative pain. Consequently, length of hospitalization and recovery time are shorter, rehabilitation and/ or return to professional activity are faster.
These attractive MIS techniques are not without difficulties; accurate pedicle screw insertion being one of the main challenges. In percutaneous and minimally invasive procedures, anatomical landmarks are no longer visible and tactile feeling is affected, increasing the risk of pedicle screw misplacement.
Several techniques have been developed to perform pedicle screw placement in MIS, based on per-operative fluoroscopy (Wiesner et al., Powers et al., Foley et al., Ringel et al.) to compensate for the lack of visible anatomical landmarks. However, such techniques present major drawbacks: higher radiation exposure for the patient and dangerous cumulative radiation exposures for the OR staff, entailing a risk of adverse health effects and increased morbidity, especially for spine surgeons (Ul Haque et al., Perisinakis et al., Rampersaud et al.).
PediGuard has proven its efficiency in open procedures, providing accurate screw placement, decreasing intra-operative radiation exposure and saving time.
To enable the use of PediGuard® technology in MIS procedures, the PediGuard® MIS Sleeve and the PediGuard® MIS Punch have been developed. They are reusable accessories to allow safe K-wire insertion while respecting the para-vertebral muscles.