Accuracy of spinal screw fixation using intraoperative O-arm navigation: Consecutive series of 118 screws

Feng, Shao-Wei; Yang, Yu-Chih; Li, Chiao-Zhu; Lin, Maofang; Chung, Tzu-Tsao; Chen, Yuan-Hao

doi:10.4103/1011-4564.177169

Cited by 4 publications

(1 citation statement)

References 1 publication

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“…In the recent past, 3-dimensional (3D) navigation has evolved to be an excellent tool and has shown promising results in overcoming the challenges associated with pedicle screw insertion. 9 - 17 However, the existing literature on the use of intraoperative O-arm-based 3D navigation, specifically for CPS insertion, is still sparse with small sample sizes.…”

Section: Introductionmentioning

confidence: 99%

Spinal Navigation for Cervical Pedicle Screws: Surgical Pearls and Pitfalls

Gan

Kaliya-Perumal

et al. 2020

Global Spine Journal

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Study Design: Retrospective cohort study. Objective: We intend to evaluate the accuracy and safety of cervical pedicle screw (CPS) insertion under O-arm-based 3-dimensional (3D) navigation guidance. Methods: This is a retrospective study of patients who underwent CPS insertion under intraoperative O-arm-based 3D navigation during the years 2009 to 2018. The radiological accuracy of CPS placement was evaluated using their intraoperative scans. Results: A total of 297 CPSs were inserted under navigation. According to Gertzbein classification, 229 screws (77.1%) were placed without any pedicle breach (grade 0). Of the screws that did breach the pedicle, 51 screws (17.2%) had a minor breach of less than 2 mm (grade 1), 13 screws (4.4%) had a breach of between 2 and 4 mm (grade 2), and 4 screws (1.3%) had a complete breach of 4 mm or more (grade 3). Six screws were revised intraoperatively. There was no incidence of neurovascular injury in this series of patients. 59 of the 68 breaches (86.8%) were found to perforate laterally, and the remaining 9 (13.2%) medially. It was noted that the C5 cervical level had the highest breach rate of 33.3%. Conclusions: O-arm-based 3D navigation can improve the accuracy and safety of CPS insertion. The overall breach rate in this study was 22.9%. Despite these breaches, there was no incidence of neurovascular injury or need for revision surgery for screw malposition.

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Section: Introductionmentioning

confidence: 99%

Spinal Navigation for Cervical Pedicle Screws: Surgical Pearls and Pitfalls

Gan

Kaliya-Perumal

et al. 2020

Global Spine Journal

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Dynamic cervical flexion/extension atlantodental interval and functional outcome of the Harms technique for posterior C1/2 fixation: A retrospective analysis of 16 atlantoaxial subluxation cases in a tertiary medical center

Meng-Lei

Liu

et al. 2022

Neurochirurgie

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Utilization of Spinal Navigation to Facilitate Hassle-Free Rod Placement during Minimally-Invasive Long-Construct Posterior Instrumentation

Kaliya-Perumal

Limthongkul

2019

Asian Spine J

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During minimally-invasive long-construct posterior instrumentation, it may be challenging to contour and place the rod as the screw heads are not visualized. To overcome this, we utilized the image data merging (IDM) facility of our spinal navigation system to visualize a coherent whole image of the construct throughout the procedure. Here, we describe this technique that was used for a patient in whom L1–L5 posterior instrumentation was performed. Using an IDM facility, screws are color coded and after placement, the final image is saved. Saved images of all previous screws are displayed and observed while placing the subsequent screws. Therefore, the entry point, depth, and mediolateral alignment of subsequent screws can be adjusted to fall in line with previous screws such that the rod can be placed without hassle. Moreover, final adjustments to the construct are kept to a minimum. The possibility of screw pullout due to force engaging the rod on poorly aligned screws is thus avoided.

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Accuracy of spinal screw fixation using intraoperative O-arm navigation: Consecutive series of 118 screws

Cited by 4 publications

References 1 publication

Spinal Navigation for Cervical Pedicle Screws: Surgical Pearls and Pitfalls

Spinal Navigation for Cervical Pedicle Screws: Surgical Pearls and Pitfalls

Dynamic cervical flexion/extension atlantodental interval and functional outcome of the Harms technique for posterior C1/2 fixation: A retrospective analysis of 16 atlantoaxial subluxation cases in a tertiary medical center

Utilization of Spinal Navigation to Facilitate Hassle-Free Rod Placement during Minimally-Invasive Long-Construct Posterior Instrumentation

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