{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,9]],"date-time":"2026-03-09T07:38:27Z","timestamp":1773041907350,"version":"3.50.1"},"reference-count":21,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,3,9]],"date-time":"2026-03-09T00:00:00Z","timestamp":1773014400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["81803917"],"award-info":[{"award-number":["81803917"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82503968"],"award-info":[{"award-number":["82503968"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100003819","name":"Natural Science Foundation of Hubei Province","doi-asserted-by":"publisher","award":["2024AFB651"],"award-info":[{"award-number":["2024AFB651"]}],"id":[{"id":"10.13039\/501100003819","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100003819","name":"Natural Science Foundation of Hubei Province","doi-asserted-by":"publisher","award":["2025AFB240"],"award-info":[{"award-number":["2025AFB240"]}],"id":[{"id":"10.13039\/501100003819","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Surg."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Minimally invasive surgery has gained widespread popularity in clinical practice. Among spinal surgeries, percutaneous pedicle screw placement (PPS) is one of the most widely performed procedures. However, it necessitates high-frequency fluoroscopic guidance to ensure accuracy, resulting in substantial radiation exposure. Therefore, it is crucial to develop a technique that is fast, safe, and minimizes radiation exposure.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>We aimed to describe a novel three-step fluoroscopy-guided technique for PPS and preliminarily evaluate the technical feasibility, procedural efficiency, and short-term safety.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This study prospectively enrolled consecutive patients who underwent PPS using either the three-step fluoroscopy-guided technique or the conventional method from December 2024 to February 2025, while data analysis was performed retrospectively. Data collected included operative time, fluoroscopy frequency, screw placement accuracy, and postoperative complications.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The three-step fluoroscopy-guided technique required an average of 4\u2009\u00b1\u20091.12 fluoroscopic exposures per screw, with an average screw placement time of 5.05\u2009\u00b1\u20090.923\u2005min. In contrast, the conventional method required an average of 18.33\u2009\u00b1\u20092.89 fluoroscopic exposures per screw and an average placement time of 15.84\u2009\u00b1\u20094.11\u2005min. And no significant complications, such as neural or vascular injuries, were reported.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This pilot study suggests that the three-step fluoroscopy-guided PPS technique is technically feasible and may reduce fluoroscopy usage while maintaining short-term procedural safety, making it a feasible and efficient alternative that warrants further validation in larger cohorts.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fsurg.2026.1719831","type":"journal-article","created":{"date-parts":[[2026,3,9]],"date-time":"2026-03-09T06:47:58Z","timestamp":1773038878000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Three-step fluoroscopy-guided percutaneous lumbar pedicle screw placement: a pilot study on technical feasibility, safety, and fluoroscopy reduction"],"prefix":"10.3389","volume":"13","author":[{"given":"Wei","family":"Wu","sequence":"first","affiliation":[{"name":"Department of Orthopaedics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology","place":["Wuhan, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ke","family":"Jia","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology","place":["Wuhan, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fanguo","family":"Kong","sequence":"additional","affiliation":[{"name":"Minimally Invasive Spinal Surgery Center, Luoyang Orthopedic-Traumatological Hospital of Henan Province (Henan Provincial Orthopedic Hospital)","place":["Zhengzhou, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chao","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology","place":["Wuhan, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2026,3,9]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"1123","DOI":"10.3390\/medicina58081123","article-title":"Minimally invasive spinal treatment (MIST)-A new concept in the treatment of spinal diseases: a narrative review","volume":"58","author":"Ishii","year":"2022","journal-title":"Med Kaunas Lith"},{"key":"B2","doi-asserted-by":"publisher","first-page":"622","DOI":"10.1016\/j.wneu.2020.05.071","article-title":"Evolution of minimally invasive lumbar spine surgery","volume":"140","author":"Momin","year":"2020","journal-title":"World Neurosurg"},{"key":"B3","doi-asserted-by":"publisher","first-page":"454","DOI":"10.5137\/1019-5149.JTN.19479-16.0","article-title":"Minimally invasive transforaminal lumbar interbody fusion with percutaneous bilateral pedicle screw fixation for lumbosacral spine degenerative diseases. 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