A Prospective Multicenter Registry on the Accuracy of Pedicle Screw Placement in the Thoracic, Lumbar, and Sacral Levels With the Use of the O-arm Imaging System and StealthStation Navigation

Kelft, Erik Van de; Costa, Francesco; Planken, D. Van der; Schils, F.

doi:10.1097/brs.0b013e318271b1fa

Cited by 208 publications

(134 citation statements)

References 19 publications

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“…Spinal navigation based on CT scans is now recognized as a valuable tool for improving the accuracy and safety of screw placement. 3,5,22,26 Cervical spinal navigation based on preoperative 3D-CT scans can effectively assist in reducing the risks of VA, spinal cord, and nerve root injuries, especially in the C1-2 region. 8,25 However, while the patient is prone during surgery, the anatomical relationships may not match those depicted on preoperative CT scans obtained while the patient was supine.…”

mentioning

confidence: 99%

Management of C1–2 traumatic fractures using an intraoperative 3D imaging–based navigation system

Costa¹,

Ortolina²,

Attuati³

et al. 2015

SPI

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OBJECT Fractures of C-1 and C-2 are complex and surgical management may be difficult and challenging due to the anatomical relationship sbetween the vertebrae and neurovascular structures. The aim of this study was to evaluate the role, reliability, and accuracy of cervical fixation using the O-arm intraoperative 3D image–based navigation system. METHODS The authors evaluated patients who underwent a navigation system–based surgery for stabilization of a fracture of C-1 and/or C-2 from August 2011 to August 2013. All of the fixation screws were intraoperatively checked and their position was graded. RESULTS The patient population comprised 17 patients whose median age was 47.6 years. The surgical procedures were as follows: anterior dens screw fixation in 2 cases, transarticular fixation of C-1 and C-2 in 1 case, fixation using the Harms technique in 12 cases, and occipitocervical fixation in 2 cases. A total of 67 screws were placed. The control intraoperative CT scan revealed 62 screws (92.6%) correctly placed, 4 (5.9%) with a minor cortical violation (< 2 mm), and only 1 screw (1.5%) that was judged to be incorrectly placed and that was immediately corrected. No vascular injury of the vertebral artery was observed either during exposition or during screw placement. No implant failure was observed. CONCLUSIONS The use of a navigation system based on an intraoperative CT allows a real-time visualization of the vertebrae, reducing the risks of screw misplacement and consequent complications.

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mentioning

confidence: 99%

Management of C1–2 traumatic fractures using an intraoperative 3D imaging–based navigation system

Costa¹,

Ortolina²,

Attuati³

et al. 2015

SPI

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“…23 The O-arm has also been used in minimally invasive spine surgery 1,3 including endoscopic surgery for resection of chordomas 8 and intraoperative CT-navigated lateral interbody fusion procedures. 4 Its role in the cervical spine, however, has been limited, both for anterior cervical surgery and posterior cervical fusion.…”

Section: Discussionmentioning

confidence: 99%

“…For this reason we have advocated performing another intraoperative CT scan before wound closure. Van de Kelft et al 23 repositioned approximately 1.8% of their screws that had been placed with CT-guided navigation.…”

Section: Posterior Upper Cervical Spine Surgery Using Image Guidancementioning

confidence: 99%

The use of intraoperative navigation for complex upper cervical spine surgery

Guppy

Chakrabarti²,

Banerjee³

2014

FOC

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Imaging guidance using intraoperative CT (O-arm surgical imaging system) combined with a navigation system has been shown to increase accuracy in the placement of spinal instrumentation. The authors describe 4 complex upper cervical spine cases in which the O-arm combined with the StealthStation surgical navigation system was used to accurately place occipital screws, C-1 screws anteriorly and posteriorly, C-2 lateral mass screws, and pedicle screws in C-6. This combination was also used to navigate through complex bony anatomy altered by tumor growth and bony overgrowth. The 4 cases presented are: 1) a developmental deformity case in which the C-1 lateral mass was in the center of the cervical canal causing cord compression; 2) a case of odontoid compression of the spinal cord requiring an odontoidectomy in a patient with cerebral palsy; 3) a case of an en bloc resection of a C2–3 chordoma with instrumentation from the occiput to C-6 and placement of C-1 lateral mass screws anteriorly and posteriorly; and 4) a case of repeat surgery for a non-union at C1–2 with distortion of the anatomy and overgrowth of the bony structure at C-2.

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“…There is no data about the radiation exposure level with intraoperative chest CT. At the field of neurosurgery or orthopedic surgery, the exposed dose was approximately half or less of that of a routine CT scan. 7,8) …”

Section: The Intersegmental Border Was Marked With Crips (Arrowhead)mentioning

confidence: 99%

Usefulness of Intraoperative Computer Tomography-Assisted Thoracoscopic Segmentectomy for Small-Sized Lung Cancer

Chang

Nakano

Okamoto

2016

ATCS

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We report the case of a patient who had synchronous primary lung cancers in the left upper lobe (S 1+2 a, S 1+2 c), and underwent S 1+2 segmentectomy. The lesion in S 1+2 c was non-palpable, and the location was confirmed using intraoperative computed tomography (CT) scan. After A 1+2 and B 1+2 had been cut, the intersegmental border was marked with clips and intraoperative CT was performed. After confirming the correct anatomical intersegmental border and the resection margin was sufficient, we cut the intersegmental border. The two lesions were both adenocarcinomas. Intraoperative CT was useful for confirming the locations of nonpalpable lesions and anatomical intersegmental borders.

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A Prospective Multicenter Registry on the Accuracy of Pedicle Screw Placement in the Thoracic, Lumbar, and Sacral Levels With the Use of the O-arm Imaging System and StealthStation Navigation

Cited by 208 publications

References 19 publications

Management of C1–2 traumatic fractures using an intraoperative 3D imaging–based navigation system

Management of C1–2 traumatic fractures using an intraoperative 3D imaging–based navigation system

The use of intraoperative navigation for complex upper cervical spine surgery

Usefulness of Intraoperative Computer Tomography-Assisted Thoracoscopic Segmentectomy for Small-Sized Lung Cancer

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