Accuracy and reliability of spinal navigation: An analysis of over 1000 pedicle screws

Ampar, Nishanth (2020) Accuracy and reliability of spinal navigation: An analysis of over 1000 pedicle screws. Journal of Orthopaedics, 18. pp. 197-203. ISSN 0972-978X

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Purpose: To estimate the rate of pedicle screw malpositioning associated with placing pedicle screws using intraoperative computed tomography (CT)-guided spinal navigation. Methods: We analysed the records of 219 patients who underwent pedicle screw fixation using O-arm-based navigation. Screw placement accuracy was evaluated on intraoperative CT scans acquired after pedicle screw insertion. Breaches were graded according to the Gertzbein classification (grade 0–III). Results: Of 1152 pedicle screws included, 47 had pedicle violations noted on intraoperative CT. Pedicle screw violation was noted for 17 of 241 screws placed in the cervical spine (overall breach rate, 7.05%; 3.73% and 3.3% with grade I and II, respectively), for 11 of 300 screws placed in the thoracic spine (overall breach rate, 3.67%; 2%, 1%, and 0.67% with grade I, II, and III, respectively), and for 22 of 611 screws placed in the lumbar spine (overall breach rate, 3.6%; 2.29% and 0.82% with grade I and II, respectively). The rate of accuracy of pedicle screw fixation was 93%, 96.33%, and 96.4% for the cervical, thoracic, and lumbar spine, respectively. Conclusions: Using O-arm-based intra-operative three-dimensional scans for navigation can improve the reliability, accuracy, and safety of pedicle screw placement, reducing the risk for reoperation and hospitalization due to implant-related complications. Further improvement may be achieved by adequate consideration of potential sources of errors.

Item Type: Article
Uncontrolled Keywords: Pedicle screw ;Intraoperative computed tomography ; O-arm navigation ; Screw malposition ; Cortical perforation.
Subjects: Medicine > KMC Manipal > Orthopaedics
Depositing User: KMC Library
Date Deposited: 03 Jul 2020 06:14
Last Modified: 03 Jul 2020 06:14

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