Journal of Medical Sciences

ORIGINAL ARTICLE
Year
: 2016  |  Volume : 36  |  Issue : 1  |  Page : 6--13

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


Shao-Wei Feng, Yun-Ju Yang, Chiao-Zhu Li, Meng-Chi Lin, Tzu-Tsao Chung, Yuan-Hao Chen 
 Department of Neurological Surgery, National Defense Medical Center, Tri-Service General Hospital, Taipei, Taiwan, Republic of China

Correspondence Address:
Yuan-Hao Chen
No. 325, Section 2, Cheng-Kung Road, Neihu 11490, Taipei, Taiwan
Republic of China

Background: Imaging-guided surgery provides intraoperative realtime navigation for spinal surgery to prevent neurovascular injury. However, the initial experience of O-arm three-dimensional (3D) navigation is less clarified. The study aims to evaluate the accuracy of O-arm 3D navigation-assisted spinal implantation. Materials and Methods: Total 118 transpedicle/lateral mass screws in 17 consecutive patients performed through O-arm 3D computed tomography (CT) imaging navigation. Screws accuracy, Visual analogue scale (VAS), and operation time were assessed. O-arm 3D navigation included 96 pedicle screws and 22 lateral mass screws. Results: There accuracy rate of screw implantation was 96.6% (114/118) without breach (Grade 0), whereas 3.4% (4/118) breach between 2 and 4 mm (Grade 2). In the cervical spinal, 12 pedicle screws were placed in 4 patients; 16.7% (2/12) exhibited a Grade 2 breach in one patient, who developed a new neurological deficit and required revision. In the lumbosacral spine, 2.78% (2/72) exhibited a Grade 2 breach in 2 patients. The mean ± standard deviation VAS of the patients in postoperative and preoperative status was 1.47 ± 0.50 and 3.58 ± 1.00, respectively. The operation time was significantly longer in O-arm navigation than in C-arm guidance (426.5 ± 180.4 vs. 317.9 ± 133.6 min, P < 0.05). Conclusion: O-arm 3D navigation achieves a relatively high accuracy of pedicle and lateral mass screws implantation. The accumulation of experience for O-arm 3D CT during initial learning curve is still warranted to promote the accuracy of screws position and shorten operation time.


How to cite this article:
Feng SW, Yang YJ, Li CZ, Lin MC, Chung TT, Chen YH. Accuracy of spinal screw fixation using intraoperative O-arm navigation: Consecutive series of 118 screws.J Med Sci 2016;36:6-13


How to cite this URL:
Feng SW, Yang YJ, Li CZ, Lin MC, Chung TT, Chen YH. Accuracy of spinal screw fixation using intraoperative O-arm navigation: Consecutive series of 118 screws. J Med Sci [serial online] 2016 [cited 2020 Aug 12 ];36:6-13
Available from: http://www.jmedscindmc.com/article.asp?issn=1011-4564;year=2016;volume=36;issue=1;spage=6;epage=13;aulast=Feng;type=0