{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T22:13:28Z","timestamp":1792793608710,"version":"4.5.0"},"reference-count":37,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2024,1,27]],"date-time":"2024-01-27T00:00:00Z","timestamp":1706313600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JPM"],"abstract":"<jats:p>Purpose: We aim to compare radiation exposure and implant-related complications of the freehand (FH) technique versus intraoperative image-guided navigation (IN) for pedicle screw placement in adolescent idiopathic scoliosis (AIS) and estimate associated lifetime attributable cancer risks. Methods: A retrospective analysis of prospectively collected data from 40 consecutive AIS patients treated with pedicle screw instrumentation using the FH technique was performed. The dose area product (DAP) and effective dose (ED) were calculated. Screw-related complications were analysed, and the age- and gender-specific lifetime attributable cancer risks were estimated. The results were compared to previously published data on IN used during surgery for AIS. Results: There were no implant-related complications in our cohort. Implant density was 86.6%. The mean Cobb angle of the main curve was 75.2\u00b0 (SD \u00b1 17.7) preoperatively and 27.7\u00b0 (SD \u00b1 10.8) postoperatively. The mean ED of our cohort and published data for the FH technique was significantly lower compared to published data on the IN technique (p &lt; 0.001). The risk for radiogenic cancer for our FH technique AIS cohort was 0.0014% for male patients and 0.0029% for female patients. Corresponding risks for IN were significantly higher (p &lt; 0.001), ranging from 0.0071 to 0.124% and from 0.0144 to 0.253% for male and female patients, respectively. Conclusion: The routine use of intraoperative navigation in AIS surgery does not necessarily reduce implant-related complications but may increase radiation exposure to the patient.<\/jats:p>","DOI":"10.3390\/jpm14020142","type":"journal-article","created":{"date-parts":[[2024,1,29]],"date-time":"2024-01-29T04:57:07Z","timestamp":1706504227000},"page":"142","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Freehand Technique for Pedicle Screw Placement during Surgery for Adolescent Idiopathic Scoliosis Is Associated with Less Ionizing Radiation Compared to Intraoperative Navigation"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4923-1064","authenticated-orcid":false,"given":"Peter","family":"Obid","sequence":"first","affiliation":[{"name":"Department of Orthopaedics and Traumatology, University Medical Center Freiburg, 79106 Freiburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8365-3258","authenticated-orcid":false,"given":"Sebastian","family":"Zahnreich","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology and Radiation Therapy, Mainz University Hospital, 55131 Mainz, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3899-9345","authenticated-orcid":false,"given":"Andreas","family":"Frodl","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics and Traumatology, University Medical Center Freiburg, 79106 Freiburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tamim","family":"Rahim","sequence":"additional","affiliation":[{"name":"Spine and Scoliosis Center, Asklepios Klinik Wiesbaden, 65197 Wiesbaden, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"Niemeyer","sequence":"additional","affiliation":[{"name":"Spine and Scoliosis Center, Asklepios Klinik Wiesbaden, 65197 Wiesbaden, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Moritz","family":"Mayr","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics and Traumatology, University Medical Center Freiburg, 79106 Freiburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,1,27]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1399","DOI":"10.1097\/00007632-199506020-00012","article-title":"Segmental pedicle screw fixation in the treatment of thoracic idiopathic scoliosis","volume":"20","author":"Suk","year":"1995","journal-title":"Spine"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"24","DOI":"10.1097\/BSD.0000000000000822","article-title":"Patient-reported Outcomes Following Surgical Intervention for Adolescent Idiopathic Scoliosis: A Systematic Review and Meta-Analysis","volume":"33","author":"Aghdasi","year":"2020","journal-title":"Clin. 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