Papers

International journal
Jun, 2017

Accuracy of pedicle screw insertion in posterior scoliosis surgery: a comparison between intraoperative navigation and preoperative navigation techniques.

European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society
  • Wei Zhang
  • ,
  • Tomoyuki Takigawa
  • ,
  • YongGang Wu
  • ,
  • Yoshihisa Sugimoto
  • ,
  • Masato Tanaka
  • ,
  • Toshifumi Ozaki

Volume
26
Number
6
First page
1756
Last page
1764
Language
English
Publishing type
Research paper (scientific journal)
DOI
10.1007/s00586-016-4930-5

PURPOSE: This study was conducted to compare the efficacy and accuracy of intraoperative navigation (O-arm or Arcadis navigation) and preoperative CT-based navigation in adolescent idiopathic scoliosis (AIS) surgery. METHODS: Sixty-seven patients with scoliosis were grouped according to the method of navigation used in their fixation surgeries. A total of 492 pedicle screws were implanted in 27 patients using intraoperative navigation, and 626 screws were implanted in 40 patients using preoperative navigation. We analyzed the postoperative CT images for pedicle violations using the Gertzbein classification. RESULTS: There was no statistical difference in the accuracy of pedicle screw placement between two groups. However, in the apical region (the apex ± 2 vertebrae), the accuracy of safe pedicle screw placement (grades 0, 1) was significantly higher in the intraoperative navigation group than in the preoperative navigation group (94.8 vs 89.2%, respectively; P = 0.035). Intraoperative navigation significantly diminished medial perforation compared to preoperative navigation (P = 0.027), and the number of screws per vertebra that could be placed in the apical region was significantly higher in intraoperative navigation group (P < 0.001). In addition, the time required for the registration procedure and insertion of one pedicle screw was 11.3 ± 2.1 min in the preoperative group, but significantly decreased to 5.1 ± 1.1 min in the intraoperative group (P < 0.001). CONCLUSIONS: Both preoperative CT-based and intraoperative navigation systems provide sufficient accuracy and safety in pedicle screw insertion for AIS surgery. Intraoperative navigation systems facilitate pedicle screw insertion in the apical region and reduce registration time during AIS surgery which improves the efficacy and accuracy of pedicle screw insertion.

Link information
DOI
https://doi.org/10.1007/s00586-016-4930-5
PubMed
https://www.ncbi.nlm.nih.gov/pubmed/28028647
ID information
  • DOI : 10.1007/s00586-016-4930-5
  • Pubmed ID : 28028647

Export
BibTeX RIS