Does Navigation Improve Pedicle Screw Placement Accuracy? Comparison Between Navigated and Non-navigated Percutaneous and Open Fixations

Innocenzi, Gualtiero; Bistazzoni, Simona; D’Ercole, Manuela; Cardarelli, Giovanni; Ricciardi, Francesco

doi:10.1007/978-3-319-39546-3_42

Cited by 41 publications

(25 citation statements)

References 38 publications

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“…In clinical work, there has been a mature binocular technology using the infrared light. Its application in the location and navigation has been spread in clinical medicine and widely used in arthroplasty and pedicle screw placement, such as MAKO and Brainlab . These proactive binocular technologies can be used in navigation and location, whose mechanisms are cumbersome and experience demanding.…”

Section: Discussionmentioning

confidence: 99%

Application of binocular visual navigation technique in diaphyseal fracture reduction

Hao

et al. 2020

Robotics Computer Surgery

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Background: Computer-assisted surgical navigation techniques have shown promise; however, currently popular systems have limitations. This paper presents the characterization and application of a binocular visual navigation technique in diaphyseal fracture reduction.Methods: A binocular visual tracker (MicronTracker) was introduced to reduce diaphyseal fractures. A transformation matrix was used to acquire the reduction parameters. A transverse diaphyseal fracture was used as a control group.Results: Precision tests were performed with the binocular system using a simulation femoral model with a transverse fracture 12 times. All residual deformations were compared and P < 0.01. Conclusions:The binocular visual navigation technique produces good results with advantages of flexibility and high positional accuracy and shows promise. The Micro-nTracker might lead to further application in the remote navigation field.

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Section: Discussionmentioning

confidence: 99%

Application of binocular visual navigation technique in diaphyseal fracture reduction

Hao

et al. 2020

Robotics Computer Surgery

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“…The use of the FH technique for screw insertion requires thorough knowledge of anatomical landmarks and pedicle morphology, with accuracy rates reported to be above 90% in most investigations 11,12,14,20) . The use of intraoperative 3-D navigation, on the other hand, has been shown to be superior in terms of radiographic accuracy 7,9,17,22) . In spinal oncology, this technique also offers the advantage of real-time localization and also aids in tumor resection.…”

Section: Discussionmentioning

confidence: 99%

“…Pedicle screw insertion can be done using traditional anatomical landmarks via the freehand (FH) technique or with use of intraoperative navigation (NV), among others. Multiple studies have shown improved radiographic accuracy with navigated screws, but the majority of these studies have combined results and included patients with degenerative spine disease, trauma, idiopathic deformity, and to a lesser degree on tumor cases 7,9,17,22) . Although the pedicle screw insertion technique does not vary based on the underlying pathology, the major challenge of placing pedicle screws in patients with metastatic disease is bone quality and potential higher risk for pedicle fractures.…”

Section: Introductionmentioning

confidence: 99%

Accuracy of Freehand versus Navigated Thoracolumbar Pedicle Screw Placement in Patients with Metastatic Tumors of the Spine

Ramos

Echt

Benton

et al. 2020

J Korean Neurosurg Soc

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Objective : To compare the accuracy and breach rates of freehand (FH) versus navigated (NV) pedicle screws in the thoracic and lumbar spine in patients with metastatic spinal tumors. Methods : A retrospective review of adult patients who underwent pedicle screw fixation in the thoracic or lumbar spine for metastatic spinal tumors between 2012 and 2018 was conducted. Breaches were assessed based on the Gertzbein and Robbins classification and only screws placed >4 mm outside of the pedicle wall (lateral or medial) were considered breached. Results : A total of 62 patients received 547 pedicle screws (average 8 per patient)-34 patients received 298 pedicle screws in the FH group and 28 patients received 249 screws in the NV group. There were 40/547 breaches, corresponding to a breach and accuracy rate of 7.3% and 92.7%, respectively. The breach rate was 9.7% in the FH group and 4.4% in the NV group (chi-squared test, p=0.017); this corresponded to an accuracy rate of 90.3% and 95.6%, respectively. Only one patient from the overall cohort (in the FH group) required revision surgery due to a medial breach abutting the spinal cord (1.6% of all patients; 2.9% of FH patients); no patient suffered organ, vessel, or neurological injury from screw breaches. Conclusion : Navigated pedicle screw placement in patients with metastatic spinal tumors has a significantly higher radiographic accuracy compared to the FH technique. However, the revision surgery was low and no patient suffered from clinically-relevant breach. Navigation also offers the advantage of real-time localization of spinal tumors and aids in targeting and resection of these lesions.

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“…6 Spinal navigation is the best way to ensure greater accuracy of transpedicular screw insertion. 7 Therefore the identification of the vertebral artery course is very important using techniques such as preoperative CTA, preoperative digital subtraction angiography (DSA), and preoperative MR scan or bony computed tomography (CT). After the diagnosis of VAF is confirmed, endovascular embolization is a reasonable treatment option.…”

Section: Discussionmentioning

confidence: 99%

Vertebral Arteriovenous Fistula: A Rare Complication Following Transpedicular Occipitocervical Fixation in a Patient with Atlantoaxial Dislocation

Ran

2018

J Neurol Surg A Cent Eur Neurosurg

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Vertebral arteriovenous fistula (AVF), a complication of a vertebral artery injury (VAI), is a rare but serious complication of upper cervical spine fixation surgery. We report a case of a 59-year-old female patient who had a vertebral AVF following transpedicular occipitocervical fixation surgery. Endovascular embolization of the AVF was successfully performed using ethylene vinyl alcohol. From this case we learned that preoperative evaluation of the course of the vertebral artery is necessary, and vertebral artery embolism is an effective and safe method to treat vertebral AVF after proof of a patent second vertebral artery.

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Does Navigation Improve Pedicle Screw Placement Accuracy? Comparison Between Navigated and Non-navigated Percutaneous and Open Fixations

Abstract: Our results confirm the advantages of the navigation technique, which ensures greater accuracy, in open as well as percutaneous procedures.

Cited by 41 publications

References 38 publications

Application of binocular visual navigation technique in diaphyseal fracture reduction

Application of binocular visual navigation technique in diaphyseal fracture reduction

Accuracy of Freehand versus Navigated Thoracolumbar Pedicle Screw Placement in Patients with Metastatic Tumors of the Spine

Vertebral Arteriovenous Fistula: A Rare Complication Following Transpedicular Occipitocervical Fixation in a Patient with Atlantoaxial Dislocation

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