Intraoperative Computed Tomography–Assisted Spinal Navigation in Dorsal Cervical Instrumentation: A Prospective Study on Accuracy Regarding Different Pathologies and Screw Types

Bertram, Ulf; Schmidt, Teresa; Clusmann, Hans; Albanna, Walid; Herren, Christian; Riabikin, Alexander; Mueller, Christian A.; Blume, Christian

doi:10.1016/j.wneu.2021.02.014

Cited by 4 publications

(2 citation statements)

References 29 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Recent advances in image guided navigation, such as intraoperative image acquisition, computer‐assisted image‐guidance, and implementation of robotic assistance, have increased the accuracy of pedicle screw placement compared to freehand‐technique and fluoroscopy guidance, reducing the risk of pedicle breaches to a minimum 7 . Use of intraoperative 3D CT (iCT) scans and computer‐assisted image‐guided screw systems yielded superior accuracy rates in spine surgery, even in cases of altered anatomy due to previous surgeries or degeneration 8,9 . Academic software tools and commercial software suites are available that enable three‐dimensional reconstruction of acquired images to support the surgeon during the process of planning and implant placement as well as to identify and understand anatomical particularities.…”

Section: Introductionmentioning

confidence: 99%

“…7 Use of intraoperative 3D CT (iCT) scans and computer-assisted imageguided screw systems yielded superior accuracy rates in spine surgery, even in cases of altered anatomy due to previous surgeries or degeneration. 8,9 Academic software tools and commercial software suites are available that enable three-dimensional reconstruction of acquired images to support the surgeon during the process of planning and implant placement as well as to identify and understand anatomical particularities. One of the commercially available software tools, Brainlab's Spine Planning Software suite offers manual planning as well as automated screw trajectory suggestion modes.…”

mentioning

confidence: 99%

See 1 more Smart Citation

Man versus machine: Automatic pedicle screw planning using registration‐based techniques compared with manual screw planning for thoracolumbar fusion surgeries

Bertram,

Köveshazi,

Michaelis

et al. 2023

Robotics Computer Surgery

Self Cite

View full text Add to dashboard Cite

ObjectiveThis study evaluates the precision of a commercially available spine planning software in automatic spine labelling and screw‐trajectory proposal.MethodsThe software uses automatic segmentation and registration of the vertebra to generate screw proposals. 877 trajectories were compared. Four neurosurgeons assessed suggested trajectories, performed corrections, and manually planned pedicle screws. Additionally, automatic identification/labelling was evaluated.ResultsAutomatic labelling was correct in 89% of the cases. 92.9% of automatically planned trajectories were in accordance with G&R grade A + B. Automatic mode reduced the time spent planning screw trajectories by 7 s per screw to 20 s per vertebra. Manual mode yielded differences in screw‐length between surgeons (largest distribution peak: 5 mm), automatic in contrast at 0 mm. The size of suggested pedicle screws was significantly smaller (largest peaks in difference between 0.5 and 3 mm) than the surgeon's choice.ConclusionAutomatic identification of vertebrae works in most cases and suggested pedicle screw trajectories are acceptable. So far, it does not substitute for an experienced surgeon's assessment.

show abstract

Section: Introductionmentioning

confidence: 99%

mentioning

confidence: 99%

Man versus machine: Automatic pedicle screw planning using registration‐based techniques compared with manual screw planning for thoracolumbar fusion surgeries

Bertram,

Köveshazi,

Michaelis

et al. 2023

Robotics Computer Surgery

Self Cite

View full text Add to dashboard Cite

show abstract

Comparison of major spine navigation platforms based on key performance metrics: a meta-analysis of 16,040 screws

et al. 2023

View full text Add to dashboard Cite

Comparison of iCT-based navigation and fluoroscopic-guidance for atlantoaxial screw placement in 78 patients with traumatic cervical spine injuries

Gierse,

Mandelka,

Medrow

et al. 2024

Eur Spine J

View full text Add to dashboard Cite

Background context Studies have shown biomechanical superiority of cervical pedicle screw placement over other techniques. However, accurate placement is challenging due to the inherent risk of neurovascular complications. Navigation technology based on intraoperative 3D imaging allows highly accurate screw placement, yet studies specifically investigating screw placement in patients with traumatic atlantoaxial injuries are scarce. The aim of this study was to compare atlantoaxial screw placement as treatment of traumatic instabilities using iCT-based navigation or fluoroscopic-guidance with intraoperative 3D control scans. Methods This was a retrospective review of patients with traumatic atlantoaxial injuries treated operatively with dorsal stabilization of C1 and C2. Patients were either assigned to the intraoperative navigation or fluoroscopic-guidance group. Screw accuracy, procedure time, and revisions were compared. Results Seventy-eight patients were included in this study with 51 patients in the navigation group and 27 patients in the fluoroscopic-guidance group. In total, 312 screws were placed in C1 and C2. Screw accuracy was high in both groups; however, pedicle perforations > 1 mm occurred significantly more often in the fluoroscopic-guidance group (P = 0.02). Procedure time was on average 23 min shorter in the navigation group (P = 0.02). Conclusions This study contributes to the available data showing that navigated atlantoaxial screw placement proves to be feasible as well as highly accurate compared to the fluoroscopic-guidance technique without prolonging the time needed for surgery. When comparing these data with other studies, the application of different classification systems for assessment of screw accuracy should be considered.

show abstract

Intraoperative Computed Tomography–Assisted Spinal Navigation in Dorsal Cervical Instrumentation: A Prospective Study on Accuracy Regarding Different Pathologies and Screw Types

Cited by 4 publications

References 29 publications

Man versus machine: Automatic pedicle screw planning using registration‐based techniques compared with manual screw planning for thoracolumbar fusion surgeries

Man versus machine: Automatic pedicle screw planning using registration‐based techniques compared with manual screw planning for thoracolumbar fusion surgeries

Comparison of major spine navigation platforms based on key performance metrics: a meta-analysis of 16,040 screws

Comparison of iCT-based navigation and fluoroscopic-guidance for atlantoaxial screw placement in 78 patients with traumatic cervical spine injuries

Contact Info

Product

Resources

About