Scientific Principle
The DSG® Technology
The DSG Technology is based on the principle that the electrical conductivity of tissue varies by the type of tissue.
Electrical conductivity is the property of a material to conduct an electrical current:
- Cortical bone has low conductivity
- Cancellous bone has medium conductivity
- Periosteum and blood have high conductivity
This parameter, varying conductivity, allows for differentiation between various tissue types while drilling a pedicle prior to screw placement.
How does the PediGuard probe work?
The PediGuard is a smart drilling single use probe for the preparation of the pilot hole. The DSG technology is at the tip of each PediGuard.
Straight PediGuard
- Straight tip
- Available in 3 different diameters: Ø2.5 mm, Ø3.2 mm and Ø4.0 mm
- Assist surgeons in preparing the pedicle for screw placement at any level of the spine
Curved PediGuard
- Curved tip
- 2 different diameters: Ø3.6 mm and Ø4.0 mm
- Ease penetration through the pedicle and removal thanks to the tapered tip
- Ease redirection during pedicle drilling: as surgeons become comfortable with the direction of the curve, they can be aware of the location of a possible breach, and hence allow proper redirection
- Mainly used in thoracic and lumbar, especially for deformity
Cannulated PediGuard
- 2 types of tips (bevel and trocar)
- Needle available in 2 sizes (120mm and 160mm) – the longest PediGuard instrument/shaft
- Progressive diameter of the Needle to ease the insertion and removal
- Graduated shaft to control the progression into the bone
- Designed primarily for helping surgeons reduce radiation exposure during minimally-invasive procedures
- Can also be used to access and drill narrow and small pedicles
Threaded PediGuard
- Threaded tip
- Design available in three diameters (Ø 4.0mm, Ø4.5mm and Ø 5.5mm)
- Stiff drilling instrument that may be used to streamline surgical steps while maintaining the accuracy for pedicle preparation for screw placement
- Potential reduction of the use of intraoperative imaging in standard and MIS procedures
Activate
Activate the PediGuard probe by pulling out the paper tab on top of the plastic handle.
Drill & Listen
Advance the PediGuard probe into the pedicle along the target trajectory for screw placement and pay close attention to the audio feedback provided.
Interpret & Redirect
A change in pitch and cadence of the audio feedback indicates a change in the tissue around the tip of the PediGuard probe.
Determine Screw Length
Using the graduated markings on the PediGuard probe note the depth to which the probe has been inserted into the pedicle and vertebral body.
For additional information, please refer to the IFU and surgical technique provided with the PediGuard probes.
BROCHURES AND PROMOTIONALS
Surgical Technique - PediGuard
Surgical Technique- PediGuardSales Brochure - DSG Connect
Sales Brochure - PediGuard
Sales Brochure - Anterior Approach
Product Catalog - PediGuard
IFU - DSG Connect App
IFU - PediGuard Assembly Instructions
IFU - Threaded PediGuard
IFU - Straight, Curved, and Cannulated PediGuard
Clinical Data
Clinical Research validates PediGuard probes in spine surgery
19 Major Peer-Reviewed Publications
With mounting clinical evidence confirming its efficacy, PediGuard devices, that integrate the DSG Technology, are becoming a compelling answer to the clinical needs associated with safe and accurate pedicle screw placement.
Screw placement accuracy and breach detection
- 97% screw placement accuracy including in osteoporotic patient (Bocquet 2005, Lubansu 2008, Chang 2009, Chaput 2011, Bai 2012, Heimen 2014, Defino 2015, Suess 2016)
- 98% breach detection, twice better than conventional technique (Bolger 2007)
- 100% medial pedicle breach anticipation (Williams 2014)
- 92.5% complex deformity, accuracy upper thoracic (Allaoui 2018)
- 3-times less neuro-monitoring alarms (Ovadia 2011)
Radiation safety and surgical efficiency
- 73% reduction of X-Ray time in MIS (Lubansu 2011)
- 30% reduction of X-Ray shots in open surgery (Chaput 2011, Bai 2012)
- 15% surgical time savings during screw placement (Bai 2012)
Surgical education
- 58% breach rate reduction among residents (Syed 2014)
New applications and techniques
- 91% cervical spine lateral mass and pedicle screw placement accuracy (Darden 2016, Koller 2018)
- “The DSG technology is useful for an optimal positioning of bi-cortical screws in the lateral mass of C1” (Kageyama 2019)
- New technique with Sacro-Iliac fusion (Sandhu 2014)
PediGuard probes, that integrate the DSG Technology, have assisted spine surgeons in accurately placing over 330,000 pedicle screws worldwide.
Publications
The following articles published in reputed peer-reviewed journals validate the accuracy and benefits of the PediGuard Probes and DSG Technology:
Usefulness of a New Electronic Conductivity Device with a Pedicle Probe and a Multi-axis Angiography Unit for Inserting a C1 Lateral Mass Screw Safely and Tightly: A Technical Note
Contribution of Dynamic Surgical Guidance to the Accurate Placement of Pedicle Screws in Deformity Surgery
Characteristics of deformity surgery in patients with severe and rigid cervical kyphosis (CK): results of the CSRS-Europe multi-centre study project
Osteotomies in ankylosing spondylitis: where, how many and how much?
Accuracy of a dynamic surgical guidance probe for screw insertion in the cervical spine: a cadaveric study
Control of Pedicle Screw Placement with an Electrical Conductivity Measurement Device: Initial Evaluation in the Thoracic and Lumbar Spine
S2-AI screw placement with the aid of electronic conductivity device monitoring: a retrospective analysis
Anticipation of vertebral pedicle breach through dynamic surgical guidance
Independent assessment of a new pedicle probe and its ability to detect pedicle breach: a cadaveric study
Comparison of the Pedicle Screws Placement Between Electronic Conductivity Device and Normal Pedicle Finder in Posterior Surgery of Scoliosis
Reduction in Radiation (Fluoroscopy) While Maintaining Safe Placement of Pedicle Screws During Lumbar Spine Fusion
Reduction in Radiation (Fluoroscopy) While Maintaining Safe Placement of Pedicle Screws During Lumbar Spine Fusion 2
The Contribution of an Electronic Conductivity Device to the Safety of Pedicle Screw Insertion in Scoliosis Surgery
Electrical conductivity measurement: a new technique to detect iatrogenic initial pedicle perforation
A preliminary study of reliability of impedance measurement to detect iatrogenic initial pedicle perforation (in the porcine model)
Presentations
Data from the clinical research of the PediGuard probes was presented at the following scientific/clinical society meetings:
Does The Use Of Dynamic Surgical Guidance Assist With Accurate Pedicle Screw Placement In Patients With Osteoporosis Or Osteopenia?
1.Defino et al. 2015. 15e Congresso Brasileiro de Coluna. SpineWeek, 2016. Singapore.
Analysis of Cervical Screw Placement Accuracy and Fixation in 137 Patients with Focus on Patients with Cervical Deformity using an Electrical Conductivity Device (ECD)
2. Koller et al, CSRS-NA Annual Scientific Meeting Poster (December 2014).
Prospektive Untersuchung der Schraubenpositionierung bei Spondylodesen zwischen Bildwandler gesteuerter (Standard) und Schraubenplatzierung mittels induktivem Pfriem.
3. Heimen et al. J. DWG annual meeting. Congress Center Leizpig, Leizpig, Germany. 11-13 Dec. 2014. Oral presentation:
Prospective Evaluation of a Free-Hand Electrical Conductivity Measuring Device to Reduce Radiation Exposure during Fluoroscopically Assisted Open or Minimally Invasive Pedicle Screw Arthrodesis
4. Lubansu et al, Eurospine Annual Scientific Meeting Poster (October 2011)
Clinical application of a specialized hand held pedicle drilling tool for pedicle screw placement in thoraco-lumbar fusions
5. Chang et al, AANS Annual Scientific Meeting Poster (2009)
Prospective evaluation of the interest of a free-hand electrical conductivity measuring device to reduce radiation exposure during fluoroscopically assisted pedicle screw fixation
6. Lubansu et al, SFCR Annual Scientific Meeting Poster (2008)
Pedicle screw placement in spinal surgery at lumbar level: interest of guidance by conductivity measurement in the placement of 104 pedicle screws
7. Bocquet, Eurospine Annual Scientific Meeting Poster (October 2006)
The Use of an Electrical Conductivity-Monitoring Device (ECMD) Shortens the Learning Curve for Accurate Placement of Pedicle Screws: A Cadaveric Study
8. Syed, et al, CNS annual meeting (2014) and SRS annual meeting (2015)
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