Objective: To evaluate the feasibility and accuracy of cervical (C(2)-C(7)) pedicle screw fixation assisted by C-arm fluoroscopy or 3D navigation system (CT-based navigation system or Iso-C 3D navigation system).
Methods: One hundred and forty-five cervical pedicle screws inserted with C-arm fluoroscopy and 187 pedicle screws inserted with 3D navigation system were observed by postoperative CT or Iso-C 3D scan. The process of navigation was investigated.
Results: In the 145 screws inserted with C-arm fluoroscopy, 133 screws are accurate (91.7%), and in the 187 screws inserted by 3D navigation system, 183 screws are accurate (97.9%) (chi2 = 6.705, P = 0.010), and the 4 misplaced screws occurred in the early stage of navigation system application. The process of navigation was investigated in twenty-five patients. With CT-based navigation, the mean time for registration and surface matching was 3.5 minutes; with Iso-C 3D navigation, the mean time for images collection and transfer was 6.2 minutes. The mean time for screw-marker insertion was 2 minutes.
Conclusions: 3D navigation system can increase accuracy of cervical pedicle screw fixation obviously.