Reduction in Radiation Exposure in Minimally Invasive Pedicle Screw Placement Using a Tubular Retractor: A Pilot Study
Round 1
Reviewer 1 Report (New Reviewer)
It need English editing from expert or editing company
The novelty of this work should be cleared in abstract and conclusion section
The author should mention from radiation protection view why that pedicle screw placement using a tube retractor and microscope is more safe. What the materials produce more saftey
In conclusion section, author refer to many works like work Clark et al., it should be moved to introduction section and just discuss your data andthe most important result in your manuscript.
Many statements need to be corrected like
line 181 "a 3month study , .......
Author Response
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Author Response.docx
Reviewer 2 Report (New Reviewer)
In the patient characteristics section, authors must use an statistical method or an appropriate statistical test to support their results, ANOVA for example.
Authors must present the errors in all the results.
In the "materials and methods" section, authors should specify which dosimeter they use to measure the radiation in the "radiation time and radiation dose during surgery" section.
Author Response
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Author Response File: Author Response.docx
Round 2
Reviewer 2 Report (New Reviewer)
None
This manuscript is a resubmission of an earlier submission. The following is a list of the peer review reports and author responses from that submission.
Round 1
Reviewer 1 Report
I read with interest this manuscript about reduction of radiation using a tubular retractor for screw placement. To my opinion, the significance of content,the scientific soundness and interest to readers is too low. Nowadays, there several different techniques to do a MIS-TLIF without radiation (navigation, robot assisted placement). Moreover, during the standard MIS-TLIF (percutanetneous screws under fluoroscopy with a MIS Wiltse approach for cage insertion) the radiation time is very low. In addition with the technique described by the authors the operating time is too long (2oo min) comparing with the usual MIS-TLIF. This should not discourage authors.
Author Response
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Reviewer 2 Report
In the age of navigation and robotics, you present an inexpensive technique for optimizing pedicle screwing. However, in my opinion, the sample is limited and the mean surgical extra time is too high
Author Response
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Reviewer 3 Report
This is a pilot study regarding reduction of radiation exposure in minimally invasive pedicle screw placement. Using a tubular retractor under a microscope might provide high accuracy for pedicle screw placement, with decreased radiation exposure for surgeons. Although patients are small and there is no control, I enjoyed this paper. There are some merit for readers.
Author Response
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Reviewer 4 Report
Dear authors,
I commend your efforts to report your novel method of reducing radiation exposure to the surgical team in PPS placement for spinal ailments. I have certain concerns that need to be answered before considering your study for publication.
- Methods to estimate the time and amount of fluoroscopy can be elaborated on since the entire study's advantage lies in the reduced radiation exposure
- I question the validity of the radiation data in a retrospective study design for its appropriateness and reliability
Author Response
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Author Response File: Author Response.docx
Round 2
Reviewer 1 Report
Dear authors the issues I addressed in the first review still remain and unfortunately your efforts do not ameliorate the scientific soundness and the significance of content of this study.
