S-Space College of Medicine/School of Medicine (의과대학/대학원) Orthopedic Surgery (정형외과학전공) Journal Papers (저널논문_정형외과학전공)
Evaluation of pedicle screw position on computerized tomography scans
- Yeom, Jin Sup; Chung, Moon Sang; Lee, Choon-Ki; Kim, Yeongho; Kim, Namkug; Lee, Jae Bum
- Issue Date
- JOURNAL OF NEUROSURGERY Vol.98 No.1, pp. 104-109
- The quality of a computerized tomography (CT) scan is significantly reduced by metal artifact caused by a pedicle
screw system. The purpose of this study was to develop a method of facilitating the evaluation of pedicle screw position
on CT scans obtained after screw insertion.
The authors developed an algorithm to process spiral CT scans in a personal computer. This uses a digital image
enhancement technique, the curve change–based intensity transformation algorithm. This method can generate a clear
image of the screw outlines while reducing metal artifact. The resulting images are displayed in arbitrary planes as well as
in axial, coronal, and sagittal planes, to support better the evaluation of pedicle screw position.
The algorithm was tested using CT scans obtained in 37 patients in whom 186 pedicle screws had been placed. There
were five types of screw systems, all of which were made of titanium alloys. In all cases algorithm-based determination of
screw position became more convenient and more accurate than when using the conventional bone window setting. In
addition, it provided better soft-tissue visualization than the bone window.
The software, by displaying clear outlines of screws and decreasing metal artifact, as well as by reconstructing the
images in arbitrary planes, was more helpful in identifying the position of pedicle screws than the conventional bone window
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