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Intraoperative 3-D Imaging Improves Accuracy of Pedicle Screw Placement in Spine Surgery

By MedImaging International staff writers
Posted on 09 Mar 2023

In spinal surgeries, surgeons mostly use implants called pedicle screws to stabilize the spine. It is important for surgeons to ensure precise positioning of these screws in order to achieve a successful outcome. Now, a new study has found that intraoperative three-dimensional (3D) imaging is superior to two-dimensional (2D) radiographs in confirming the accuracy of pedicle screw placement during spine surgery.

In the study, researchers at Hospital for Special Surgery (HSS, New York City, NY, USA) compared the accuracy of biplanar radiograph (BPR) versus 3D imaging when assessing intraoperative pedicle screw placement. The study was the first to compare the differences in intraoperative biplanar radiography and 3D imaging for pedicle screw accuracy in thoracic and lumbar cases using robotic technology. The study involved 103 patients who underwent spinal fusion performed by a single surgeon between 2019 and 2022. The investigators assessed pedicle screw placement with both intraoperative BPR and 3D imaging in all the cases.

The investigators compared CT scans taken after surgery to the findings of intraoperative BPR and 3D imaging in order to detect either false-positive or false-negative readings. Postoperative CT imaging revealed a clinically significant number of patients who had false-negative and false-positive screw placement readings on BPR. However, the investigators found the screw position shown on intraoperative 3D imaging to be much more accurate.

“Based on our study, BPR imaging may lead one to think a screw is acceptable when in fact it is not, and also may miss many screws that are not in fact acceptable,” said Darren Lebl, MD, a spine surgeon at HSS and principal investigator of the study. “In our study, it was approximately one percent of cases where this occurred. However, for surgeons and centers that implant hundreds and thousands of screws per year, this is going to result in a significant clinical impact for many people. Even one misplaced screw can have a significant impact for a patient, a surgeon, and a hospital system. Therefore, based on these findings, we suggest that for intraoperative confirmation of screw position 3D imaging may soon represent a new standard of care.”

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62 (473.97613525391): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets_archive as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294796469 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

63 (!!!!! 1121.0441589355): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294796469 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294796469 AND published='1' LIMIT 1

64 (137.0906829834): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294796469 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294796469 AND published='1' LIMIT 1

65 (201.94053649902): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294796469 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294796469 AND published='1' LIMIT 1

66 (!!!!! 2399.9214172363): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294796469 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294796469 AND published='1' LIMIT 1

67 (!!!!! 1062.1547698975): select cover from jos_number where journalid in (5) and cover is not null order by left(issue,2)+right(issue,2)*12 desc limit 1

68 (420.80879211426): SELECT fid FROM jos_deeppockets WHERE id=294796469 AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE id=294796469 AND published='1' LIMIT 1

69 (115.15617370605): SELECT id,name,sponsor_text FROM jos_deeppockets dp left outer join jos_channel_sponsor cs on dp.id=cs.fid WHERE cat=10 AND TYPE='file_folder' AND published=1 AND id=211 ORDER BY `ordering`

70 (41.007995605469): select jos_twitters.link from jos_twitters where cat=10

71 (27.179718017578): select jos_facebook.link from jos_facebook where cat=10

72 (46.014785766602): select jos_google_plus.link from jos_google_plus where cat=10

73 (41.961669921875): select jos_linkedin.link from jos_linkedin where cat=10

74 (119.92454528809): SELECT fid FROM jos_deeppockets WHERE id=294796469 AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE id=294796469 AND published='1' LIMIT 1

75 (36.001205444336): SELECT id,name,sponsor_text FROM jos_deeppockets dp left outer join jos_channel_sponsor cs on dp.id=cs.fid WHERE cat=10 AND TYPE='file_folder' AND published=1 AND id=211 ORDER BY `ordering`

76 (267.98248291016): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294796469 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

77 (169.99244689941): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294796469 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

78 (77.962875366211): SELECT id,name,title FROM jos_deeppockets WHERE cat=10 AND TYPE='file_folder' AND published=1 AND id != 294743300 AND id != 294743301 AND id != 294743302 AND id != 294743303 AND id != 294743304 AND id != 294743305 AND id != 294743306 AND id != 294743307 AND id != 294743308 AND id != 294743309 AND id != 294743310 AND metakey != 'aacc' ORDER BY `ordering`

79 (251.05476379395): SELECT show_live FROM jos_com_show_setting LIMIT 1

80 (49.114227294922): SELECT show_live FROM jos_com_show_setting LIMIT 1

81 (86.069107055664): SELECT show_live FROM jos_com_show_setting LIMIT 1

82 (27.894973754883): SELECT show_live FROM jos_com_show_setting LIMIT 1

83 (61.03515625): SELECT show_live FROM jos_com_show_setting LIMIT 1

84 (31.948089599609): SELECT show_live FROM jos_com_show_setting LIMIT 1

85 (!!!!! 1213.7889862061): SELECT show_live FROM jos_com_show_setting LIMIT 1

86 (66.041946411133): SELECT show_live FROM jos_com_show_setting LIMIT 1

87 (28.848648071289): SELECT show_live FROM jos_com_show_setting LIMIT 1

88 (25.98762512207): SELECT show_live FROM jos_com_show_setting LIMIT 1

89 (25.033950805664): SELECT show_live FROM jos_com_show_setting LIMIT 1

90 (25.033950805664): SELECT show_live FROM jos_com_show_setting LIMIT 1

91 (24.795532226562): SELECT show_live FROM jos_com_show_setting LIMIT 1

92 (25.98762512207): SELECT show_live FROM jos_com_show_setting LIMIT 1

93 (42.915344238281): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294796469 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

94 (26.941299438477): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294796469 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

95 (31.948089599609): SELECT id,name,title FROM jos_deeppockets WHERE cat=10 AND TYPE='file_folder' AND published=1 AND id != 294743300 AND id != 294743301 AND id != 294743302 AND id != 294743303 AND id != 294743304 AND id != 294743305 AND id != 294743306 AND id != 294743307 AND id != 294743308 AND id != 294743309 AND id != 294743310 AND metakey != 'aacc' ORDER BY `ordering`

96 (252.96211242676): SELECT show_live FROM jos_com_show_setting LIMIT 1

97 (51.021575927734): SELECT show_live FROM jos_com_show_setting LIMIT 1

98 (79.870223999023): SELECT show_live FROM jos_com_show_setting LIMIT 1

99 (36.001205444336): SELECT show_live FROM jos_com_show_setting LIMIT 1

100 (79.154968261719): SELECT show_live FROM jos_com_show_setting LIMIT 1

101 (45.061111450195): SELECT show_live FROM jos_com_show_setting LIMIT 1

102 (60.081481933594): SELECT show_live FROM jos_com_show_setting LIMIT 1

103 (43.869018554688): SELECT show_live FROM jos_com_show_setting LIMIT 1

104 (51.021575927734): SELECT show_live FROM jos_com_show_setting LIMIT 1

105 (36.001205444336): SELECT show_live FROM jos_com_show_setting LIMIT 1

106 (77.962875366211): SELECT show_live FROM jos_com_show_setting LIMIT 1

107 (39.815902709961): SELECT show_live FROM jos_com_show_setting LIMIT 1

108 (59.843063354492): SELECT show_live FROM jos_com_show_setting LIMIT 1

109 (35.04753112793): SELECT show_live FROM jos_com_show_setting LIMIT 1

110 (401.02005004883): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294796469 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294796469 AND published='1' LIMIT 1

111 (87.976455688477): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294796469 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294796469 AND published='1' LIMIT 1

112 (121.11663818359): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294796469 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

113 (60.081481933594): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets_archive as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294796469 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

114 (113.96408081055): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294796469 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294796469 AND published='1' LIMIT 1

115 (48.87580871582): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294796469 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294796469 AND published='1' LIMIT 1

116 (332.11708068848): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.id=294796469 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

117 (288.96331787109): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets_archive as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.id=294796469 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

118 (56.982040405273): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.id=294796449 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

119 (321.1498260498): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets_archive as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.id=294796449 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

120 (740.05126953125): SELECT dp.name, dp.id, dp2.name as channel, ex.name as author_name, ex.specialization, ex.images FROM jos_deeppockets as dp LEFT JOIN jos_experts as ex ON ex.id = dp.author LEFT JOIN jos_deeppockets as dp2 ON dp2.id = dp.fid WHERE dp.author != 0 AND dp.cat = 10 AND dp.published = 1 AND ( (dp.fid = 294743300) OR (dp.fid = 294743301) OR (dp.fid = 294743302) OR (dp.fid = 294743303) OR (dp.fid = 294743304) OR (dp.fid = 294743305) OR (dp.fid = 294743306) OR (dp.fid = 294743307) OR (dp.fid = 294743308) OR (dp.fid = 294743309) OR (dp.fid = 294743310) ) ORDER BY RAND() LIMIT 1

121 (526.90505981445): SELECT dp.name, dp.id, dp2.name as channel, ex.name as author_name, ex.specialization, ex.images FROM jos_deeppockets as dp LEFT JOIN jos_experts as ex ON ex.id = dp.author LEFT JOIN jos_deeppockets as dp2 ON dp2.id = dp.fid WHERE dp.author != 0 AND dp.cat = 10 AND dp.published = 1 AND ( (dp.fid = 294743300) OR (dp.fid = 294743301) OR (dp.fid = 294743302) OR (dp.fid = 294743303) OR (dp.fid = 294743304) OR (dp.fid = 294743305) OR (dp.fid = 294743306) OR (dp.fid = 294743307) OR (dp.fid = 294743308) OR (dp.fid = 294743309) OR (dp.fid = 294743310) ) ORDER BY RAND() LIMIT 1

122 (91.075897216797): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294796469 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294796469 AND published='1' LIMIT 1

123 (76.055526733398): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294796469 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294796469 AND published='1' LIMIT 1

124 (70.810317993164): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294796469 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294796469 AND published='1' LIMIT 1

125 (53.882598876953): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294796469 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294796469 AND published='1' LIMIT 1

126 (71.048736572266): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294796469 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294796469 AND published='1' LIMIT 1

127 (56.982040405273): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294796469 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294796469 AND published='1' LIMIT 1

128 (334.9781036377): SELECT * FROM trending_articles WHERE `journal_id` = 10 AND `timestamp` <= NOW() + INTERVAL 7 DAY ORDER BY `order`

129 (!!!!! 67009.925842285): SELECT * FROM jos_deeppockets WHERE jos_deeppockets.cat = 10 AND jos_deeppockets.type = 'deeppockets_item' AND jos_deeppockets.published = 1 AND jos_deeppockets.created + INTERVAL 14 DAY >= NOW() ORDER BY jos_deeppockets.hits DESC LIMIT 7

130 (90.122222900391): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294796469 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294796469 AND published='1' LIMIT 1

131 (46.968460083008): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294796469 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294796469 AND published='1' LIMIT 1

132 (426.05400085449): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294796469 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294796469 AND type='deeppockets_item' AND published='1' LIMIT 1

133 (!!!!! 641994.95315552): ( SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.video != '' AND dp.video_source != '' AND dp.cat = 10 AND dp.published = 1 AND dp.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) UNION ( SELECT dpa.id, dpa.name, dpa.title, dpa.video, dpa.video_source, dpa.created FROM jos_deeppockets_archive AS dpa WHERE dpa.video != '' AND dpa.video_source != '' AND dpa.cat = 10 AND dpa.published = 1 AND dpa.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) ORDER BY created DESC LIMIT 3

134 (114.91775512695): ( SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.video != '' AND dp.video_source != '' AND dp.cat = 10 AND dp.published = 1 AND dp.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) UNION ( SELECT dpa.id, dpa.name, dpa.title, dpa.video, dpa.video_source, dpa.created FROM jos_deeppockets_archive AS dpa WHERE dpa.video != '' AND dpa.video_source != '' AND dpa.cat = 10 AND dpa.published = 1 AND dpa.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) ORDER BY created DESC LIMIT 3

135 (36.954879760742): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294800513 LIMIT 1

136 (29.087066650391): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294800513 LIMIT 1

137 (42.915344238281): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294800359 LIMIT 1

138 (30.040740966797): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294800359 LIMIT 1

139 (27.179718017578): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294800361 LIMIT 1

140 (28.133392333984): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294800361 LIMIT 1

141 (777.00614929199): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294796469 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

142 (442.9817199707): SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294796469 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

143 (127.07710266113): SELECT name FROM jos_deeppockets WHERE id=211

144 (33.140182495117): SELECT name FROM jos_deeppockets WHERE id=211

145 (993.01338195801): SELECT *, DATE_FORMAT(publish_up,'%d %b %Y') AS date_publish_up, DATE_FORMAT(publish_down,'%d %b %Y') AS date_publish_down FROM jos_events WHERE state=1 AND publish_up > NOW() and extra_info REGEXP '((;)|(^))211((;)|($))' AND catid IN (0,110) ORDER BY publish_up ASC LIMIT 3

146 (586.03286743164): SELECT *, DATE_FORMAT(publish_up,'%d %b %Y') AS date_publish_up, DATE_FORMAT(publish_down,'%d %b %Y') AS date_publish_down FROM jos_events WHERE state=1 AND publish_up > NOW() and extra_info REGEXP '((;)|(^))211((;)|($))' AND catid IN (0,110) ORDER BY publish_up ASC LIMIT 3

147 (165.93933105469): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294796469 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294796469 AND published='1' LIMIT 1

148 (149.96528625488): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294796469 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294796469 AND published='1' LIMIT 1

149 (!!!!! 9773.9696502686): TRUNCATE TABLE jos_trademed_module

150 (208.85467529297): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294796469 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

151 (123.02398681641): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets_archive as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294796469 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

152 (482.08236694336): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294796469 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

153 (133.99124145508): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294796469 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

154 (103.95050048828): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294796469 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294796469 AND published='1' LIMIT 1

155 (103.95050048828): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294796469 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294796469 AND published='1' LIMIT 1

156 (!!!!! 1434.0877532959): SELECT jos_item.* FROM jos_item INNER JOIN jos_number ON jos_item.numberID=jos_number.id WHERE 1=1 AND (jos_item.imgMini<>'') AND jos_item.type='L' AND jos_item.numberID= ( SELECT jos_number.id FROM jos_number WHERE jos_number.journalID IN (10) and jos_number.id in (select distinct jos_number.id from jos_number join jos_item on jos_item.numberid=jos_number.id where jos_item.type='P') ORDER BY (CONVERT(SUBSTRING(issue,1,2),SIGNED) + (CONVERT(SUBSTRING(issue,3,2),SIGNED)*100)) DESC LIMIT 0,1 ) ORDER BY RAND() DESC LIMIT 6

157 (119.92454528809): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294796469 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294796469 AND published='1' LIMIT 1

158 (92.983245849609): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294796469 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294796469 AND published='1' LIMIT 1

159 (!!!!! 2434.0152740479): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294796469 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294796469 AND type='deeppockets_item' AND published='1' LIMIT 1

160 (!!!!! 4070.9972381592): select distinct links.* from jos_textlinks links join jos_textlinks_placement placement on links.id=placement.link_id where journal_id=(10) and (channel_id=0 or channel_id is null)

161 (88.930130004883): select distinct links.* from jos_textlinks links join jos_textlinks_placement placement on links.id=placement.link_id where journal_id=(10) and (channel_id=0 or channel_id is null)

162 (906.94427490234): SELECT livesite FROM jos_dp_categories WHERE id=10 AND published='1' LIMIT 1

163 (847.10121154785): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294796469 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294796469 AND published='1' LIMIT 1

164 (232.21969604492): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294796469 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294796469 AND published='1' LIMIT 1

165 (!!!!! 2107.8586578369): select jos_twitters.link from jos_twitters where cat=10

166 (66.041946411133): select jos_facebook.link from jos_facebook where cat=10

167 (296.11587524414): select jos_google_plus.link from jos_google_plus where cat=10

168 (92.029571533203): select jos_linkedin.link from jos_linkedin where cat=10

169 (340.93856811523): update jos_bannersmanager_banner set impmade=impmade+1 where id in(14615,14202,14203)

170 (!!!!! 1244.068145752): insert into jos_banners_delta values (14615,'2025-04-30 16:26:14','18.191.132.143','view'),(14202,'2025-04-30 16:26:14','18.191.132.143','view'),(14203,'2025-04-30 16:26:14','18.191.132.143','view')

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