3D-based navigation in posterior stabilisations of the cervical and thoracic spine: problems and benefits. Results of 451 screws

Jarvers, Jan-Sven; Katscher, S.; Franck, Alexander; Glasmacher, Stefan; Schmidt, Carlos A.; Blattert, T. R.; Josten, Christoph

doi:10.1007/s00068-011-0098-1

Cited by 20 publications

(10 citation statements)

References 39 publications

(46 reference statements)

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“…To date, CPS is one of the most advanced procedures for treatment of the cervical instability, and many recent studies have demonstrated the excellent efficacy of its application on the cervical spine surgery [ 6 - 10 ]. Moreover, the advanced intra-operative imaging techniques, such as the navigation-guided spine surgery or three-dimensional image-based navigation systems, can provide a greater accuracy and safety during the CPS insertion which results in the popularity of CPS fixation among cervical spine surgeons [ 9 - 12 ].…”

Section: Introductionmentioning

confidence: 99%

Morphometric evaluation of subaxial cervical spine using multi-detector computerized tomography (MD-CT) scan: the consideration for cervical pedicle screws fixation

Chanplakorn

Kraiwattanapong

Aroonjarattham

et al. 2014

BMC Musculoskelet Disord

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BackgroundCervical pedicle screw (CPS) insertion is a technically demanding procedure. The quantitative understanding of cervical pedicle morphology, especially the narrowest part of cervical pedicle or isthmus, would minimize the risk of catastrophic damage to surrounding neurovascular structures and improve surgical outcome. The aim of this study was to investigate morphology and quantify cortical thickness of the cervical isthmus by using Multi-detector Computerized Tomography (MD-CT) scan.MethodsThe cervical CT scans were performed in 74 patients (37 males and 37 females) with 1-mm slice thickness and then retro-reconstructed into sagittal and coronal planes to measure various cervical parameters as follows: outer pedicle width (OPW), inner pedicle width (IPW), outer pedicle height (OPH), inner pedicle height (IPH), pedicle cortical thickness, pedicle sagittal angle (PSA), and pedicle transverse angle (PTA).ResultsTotal numbers of 740 pedicles were measured in this present study. The mean OPW and IPW significantly increased from C3 to C7 while the mean OPH and IPH of those showed non-significant difference between any measured levels. The medial-lateral cortical thickness was significantly smaller than the superior-inferior one. PTA in the upper cervical spine was significantly wider than the lower ones. The PSA changed from upward inclination at upper cervical spine to the downward inclination at lower cervical spine.ConclusionsThis study has demonstrated that cervical vertebra has relatively small and narrow inner pedicle canal with thick outer pedicle cortex and also shows a variable in pedicle width and inconsistent transverse angle. To enhance the safety of CPS insertion, the entry point and trajectories should be determined individually by using preoperative MD-CT scan and the inner pedicle width should be a key parameter to determine the screw dimensions.

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Section: Introductionmentioning

confidence: 99%

Morphometric evaluation of subaxial cervical spine using multi-detector computerized tomography (MD-CT) scan: the consideration for cervical pedicle screws fixation

Chanplakorn

Kraiwattanapong

Aroonjarattham

et al. 2014

BMC Musculoskelet Disord

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“…The most common application of image-guided spine surgery is nowadays pedicle screws placement [8,15]; the clinical benefits in terms of increased accuracy and reduced exposure [6,9] to ionizing radiation are well documented.…”

Section: Discussionmentioning

confidence: 99%

Navigation-assisted surgery for tumors of the spine

et al. 2013

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“…Принципиальным преимуществом этой технологии, в отличие от обычной 2D-флюоронавигации, является возможность получения трехмерных интраоперационных изображений позвоночника с последующим контролем за проведением винтов в аксилярной, коронарной и поперечной проекциях. К существенным недостаткам 3D-флюоронавигации относят невысокое качество получаемых интраоперационных изображений, особенно у больных с остеопорозом, большой массой тела и/или выраженными нарушениями анатомии позвоночника [5]. Кроме того, небольшой диаметр детектора требует многократного сбора информации, особенно при установке больших по протяженности конструкций.…”

Section: таблицаunclassified

The 3d-Ct Navigation Technology for Surgical Treatment of Children With Idiopathic Scoliosis

Vissarionov¹,

Kokushin²,

Drozdetsky³

et al. 2012

Hir. pozvonoč.

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To study an applicability of active optical 3D-CT navigation system for surgical treatment of children with idiopathic scoliosis. Material and Methods. The study included 12 children aged 14-17 years with thoracic and thoracolumbar idiopathic scoliosis. The magnitude of scoliotic deformity varied from 52° to 80° (average 70°). Correction of deformity was performed using multisegmental pedicle screw instrumentation inserted under the guidance of active optical 3D-CT navigation system. At the stage of navigation an estimation of mean-square registration error, and monitoring of time required for registration and formation of bone canals for pedicle screws were performed. Results. In 96.6 % of cases the pedicle screws were placed in all preplanned pedicles. In other 9 vertebrae (3.4 %) the screw placement was complicated by pedicle fracture and screw trajectory deviation. There were no cases of neurological and infection complications, and instrumentation loosening in the studied patients. Conclusion. Active optical 3D-CT navigation using preoperative CT images and anatomical landmark registration is applicable in correction of idiopathic scoliosis in children. Multisegmental transpedicular fixation allows reducing the length of metal fixation zone, and achieving maximum curve correction and reliable stability.

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3D-based navigation in posterior stabilisations of the cervical and thoracic spine: problems and benefits. Results of 451 screws

Cited by 20 publications

References 39 publications

Morphometric evaluation of subaxial cervical spine using multi-detector computerized tomography (MD-CT) scan: the consideration for cervical pedicle screws fixation

Morphometric evaluation of subaxial cervical spine using multi-detector computerized tomography (MD-CT) scan: the consideration for cervical pedicle screws fixation

Navigation-assisted surgery for tumors of the spine

The 3d-Ct Navigation Technology for Surgical Treatment of Children With Idiopathic Scoliosis

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