[Accuracy of CT-based navigation of pedicle screws implantation in the cervical spine compared with X-ray fluoroscopy technique]

Zhonghua Wai Ke Za Zhi. 2005 Oct 15;43(20):1328-30.
[Article in Chinese]

Abstract

Objective: To evaluate the feasibility and accuracy of cervical spine pedicle screw fixation assisted by X-ray fluoroscopy and CT-based navigation system.

Methods: 145 cervical pedicle screws were placed assisted by X-ray fluoroscopy and 159 cervical pedicle screws were placed assisted by CT-based navigation system. Screw positions were evaluated by postoperative CT scans or C-arm X-ray 3 dimensional reconstruction.

Results: In the computer- assisted group, 155 (97.5%) screws were found completely within their pedicles compared with 133 (91.7%) correctly placed screws in the X-ray assisted group (P < 0.05). The process of navigation investigated in twenty patients showed that the mean time for registration and surface matching was 3.5 (range from 2 to 8 minutes) minutes and the mean time for screw-marker insertion was 2 (range from 1 to 3.5 minutes) minutes with the mean position deviation 0.31 mm (0.12-0.56 mm) per screw. Only twice C-arm fluoroscopy were performed to verify the accuracy of one screw position intraoperatively. No severe complications like neurovascular lesion occurred in both groups.

Conclusion: CT-based navigation system can increase the accuracy of cervical pedicle screw implantation significantly.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Bone Screws*
  • Cervical Vertebrae* / diagnostic imaging
  • Cervical Vertebrae* / surgery
  • Female
  • Fluoroscopy
  • Humans
  • Imaging, Three-Dimensional
  • Male
  • Middle Aged
  • Retrospective Studies
  • Spinal Fusion / methods*
  • Surgery, Computer-Assisted*
  • Tomography, X-Ray Computed* / methods