Accuracy and Safety in Pedicle Screw Placement in the Thoracic and Lumbar Spines: Comparison Study between Conventional C-Arm Fluoroscopy and Navigation Coupled with O-Arm (R) Guided Methods

作者：Shin Myung Hoon; Ryu Kyeong Sik^*; Park Chun Kun

来源：Journal of Korean Neurosurgical Society, 2012, 52(3): 204-209.

DOI：10.3340/jkns.2012.52.3.204

• Cervical trauma
• Sub-axial injury classification scale
• Cervical spine injury
• Interobserver agreement
• Intraobserver reliability

Objective : The authors performed a retrospective study to assess the accuracy and clinical benefits of a navigation coupled with O-arm (R) system guided method in the thoracic and lumbar spines by comparing with a C-arm fluoroscopy-guided method. %26lt;br%26gt;Methods : Under the navigation guidance, 106 pedicle screws inserted from 7 to Si in 24 patients, and using the fluoroscopy guidance, 204 pedicle screws from 15 to Si in 45 patients. The position of screws within the pedicle was classified into four groups, from grade 0 (no violation cortex) to 3 (more than 4 mm violation). The location of violated pedicle cortex was also assessed. Intra-operative parameters including time required for preparation of screwing procedure, times for screwing and the number of X-ray shot were assessed in each group. %26lt;br%26gt;Results : Grade 0 was observed in 186 (91.2%) screws of the fluoroscopy-guided group, and 99 (93.4%) of the navigation-guided group. Mean time required for inserting a screw was 3.8 minutes in the fluoroscopy-guided group, and 4.5 minutes in the navigation-guided group. Mean time required for preparation of screw placement was 4 minutes in the fluoroscopy-guided group, and 19 minutes in the navigation-guided group. The fluoroscopy-guided group required mean 8.9 times of X-ray shot for each screw placement. %26lt;br%26gt;Conclusion : The screw placement under the navigation-guidance coupled with O-arm (R) system appears to be more accurate and safer than that under the fluoroscopy guidance, although the preparation and screwing time for the navigation-guided surgery is longer than that for the fluoroscopy-guided surgery.

• 出版日期2012-9