RT Journal Article SR Electronic T1 Feasibility of Endoscopic Inspection of Pedicle Wall Integrity in a Live Surgery Model JF International Journal of Spine Surgery JO Int J Spine Surg FD International Society for the Advancement of Spine Surgery SP 5030 DO 10.14444/5030 A1 Kristen Radcliff A1 Harvey Smith A1 Bobby Kalantar A1 Robert Isaacs A1 Barrett Woods A1 Alexander R. Vaccaro A1 James Brannon YR 2018 UL http://ijssurgery.com//content/early/2018/05/30/5030.abstract AB Background Perforations of the pedicle wall during cannulation can occur with experienced surgeons. Direct endoscopic visualization has not been used to inspect pedicles previously due to bone bleeding obscuring the camera visualization. The hypothesis of this study was that endoscopic visualization of pedicle wall integrity was technically feasible and would enable identification of clinically significant pedicle breaches. Methods A live porcine model was used. Eight lumbar pedicles were cannulated. Clinically significant breaches were created. An endoscope was introduced and was used to inspect the pedicles.Results All lumbar pedicles were endoscopically visible at a systolic pressure of 100 mm Hg. Clinically relevant anatomic structures and iatrogenic pathology, such as medial, lateral, and anterior breaches, were identified. There were no untoward events resulting from endoscopic inspection of the pedicle endosteal canal.Conclusions Endoscopic inspection of lumbar pedicles was safe and effective. The findings on endoscopic inspection corresponded with the ball-tip probe palpation techniques. Additional techniques, such as selection between 2 tracts, was possible with the endoscopic technique.