masterThesis
Comprobando la integridad del trayecto pedicular torácico: ¿es valido el uso del palpador pedicular? Técnica en cadáveres
Fecha
2015Autor
Moreno Mora, Daniel Fernando
Institución
Resumen
Introduction: In neurosurgical practice the use of thoracic pedicle screws has been increasing in the treatment of different pathologies in the thoracic spine. Since the original description, the proper channeling of the tract is confirmed using the probe, however the validity and safety of the instrument is limited and there is a risk of serious complications. In this study, the safety and validity of using the probe is checked to diagnose thoracic pedicle integrity way.
Methods: Thoracic pedicle cadaveric specimens were channeled in which randomly were classified as normal (intact) or abnormal (violated). Subsequently four spine surgeons at various levels of expertise, assessed the pedicle way. Studies of agreement were obtained, Kappa coefficient, total percentage of accuracy, sensitivity, specificity, PPV and NPV and the area under the ROC curve to determine the accuracy of the test is performed.
Results: The accuracy and validity in the diagnosis of pedicle tract and pedicle violation are directly related to the training and experience of the surgeon, the most experienced evaluator obtained the best results. The use of the probe has good accuracy, 0.86 area under the ROC curve, for the diagnosis of the pedicle injury.
Discussion: The precise detection of a pedicle tract, presence or absence of a tract violation is dependent of the level of experience of the surgeon; the diagnosis of the breach pedicle varies according to its localization.