The use of CT in the development and implementation of a preoperative protocol to aid in pedicle screw placement during scoliosis surgery

Scoliosis surgical constructs, using pedicle screws, provide increased fixed penetrable points for rod attachment. This allows improved curve correction and increases hardware stability. We have implemented a multidetector CT evaluation of the spine with post-process image manipulation to aid pedicle screw placement for deformity correction. Preoperative scanning was done with a Philips Brilliance 16 multislice CT scanner. The created image dataset provided valuable preoperative information regarding pedicle morphology, suitability for screw placement and preoperative screw planning. Projected intraoperatively, the images increased the surgeon’s confidence during screw placement, especially in large deformities with severe rotation. Improving pre- and intraoperative pedicle information is a valuable tool in operative management of children with spinal deformity.