Neurology India Medknow Publications on behalf of the Neurological Society of India ISSN: 0028-3886 EISSN: 1998-4022 Vol. 59, Num. 5, 2011, pp. 796-796

Neurology India, Vol. 59, No. 5, September-October, 2011, pp. 796

Correspondence

Authors' reply

P Ailawadhi, D Agrawal, GD Satyarthee, D Gupta, S Sinha, AK Mahapatra

Department of Neurosurgery, JPN Apex Trauma Centre, All India Institute of Medical Sciences, New Delhi, India
Correspondence Address: D Agrawal, Department of Neurosurgery, JPN Apex Trauma Centre, All India Institute of Medical Sciences, New Delhi, India, drdeepak@gmail.com

Code Number: ni11252

Sir,

We thank Dr R Krishnakumar ^[1] for taking the time to go through our study ^[2] . However, the study by Kim et al.,^[3] also showed an 8% rate of significant pedicle wall violations on postoperative computed tomography scan. This was despite all pedicle screw insertions being performed by 'experts'. Even in the study by Parker et al, ^[4] there was a 1.7% pedicle breach rate with eight patients having to undergo repeat surgery for the removal of these screws.

From a patient's perspective, a hospital should aim to maintain consistency of surgical results across patients and across surgeons. O-arm provides the ability for even novice surgeons to get results similar to experts consistently. It also provides simulated training on real patients (not on cadavers or sawbone models) which is unparalleled in spine surgery. We believe that the use of O-arm actually shortens the learning curve for freehand pedicle screw insertions and is a valuable tool in any large residency program for spinal surgery.

References

1.	Krishnakumar R. Comment on: Use of O-arm for spinal surgery in academic institution in India: Experience from JPN apex trauma centre. Neurol India 2011;59:795-6.   Back to cited text no. 1  [PUBMED]
2.	Ailawadhi P, Agrawal D, Satyarthee GD, Gupta D, Sinha S, Mahapatra AK. Use of O-arm for spinal surgery in academic institution in India: Experience from JPN apex trauma centre. Neurol India 2011;59:590-3.  Back to cited text no. 2  [PUBMED]
3.	Kim YJ, Lenke LG. Thoracic pedicle screw placement: Free-hand technique. Neurol India 2005;53:512-9.  Back to cited text no. 3  [PUBMED]
4.	Parker SL, McGirt MJ, Farber SH, Amin AG, Rick AM, Suk I, et al. Accuracy of free-hand pedicle screws in the thoracic and lumbar spine: Analysis of 6816 consecutive screws. Neurosurgery 2011;68:170-8.  Back to cited text no. 4  [PUBMED]  [FULLTEXT]

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