[Accuracy of fluoroscopic navigation of pedicle screws. CT-based evaluation of bone screw placement].
While the advantages of C-arm navigation in computer-assisted spine surgery are obvious, the accuracy of pedicle screw placement with virtual fluoroscopy still needs to be verified. The C-arm-based ION system (Medtronic Sofamor Danek) was used to navigate pedicle screw insertion in patients undergoing spinal surgery for various conditions. In a prospective study, a total of 160 screws were inserted in the first 30 consecutive patients since introduction of the system at our institution: 54 at the thoracic spine (highest level: TH4) and 106 at the lumbar spine. Computed tomography (CT) scans were performed postoperatively by two independent radiologists to control the accuracy of screw placement at the level of the pedicles after reconstruction of axial images according to Laine et al. The comparison of the calculated accuracy rate of pedicle screw placement using virtual fluoroscopy with reported results achieved with CT-based navigation shows similar results for virtual fluoroscopy and a remarkable increase of accuracy in comparison to reports on conventional pedicle screw placement.
Fritsch
E
E
Orthopädische Universitätsklinik, 66421 Homburg/Saar. ekkehard.fritsch@uniklinik-saarland.de
Duchow
J
J
Seil
R
R
Grunwald
I
I
Reith
W
W
D001863:Bone Screws; D004867:Equipment Design; D005471:Fluoroscopy / Q000295:instrumentation*; D006801:Humans; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging / Q000601:surgery; D011183:Postoperative Complications / Q000000981:diagnostic imaging / Q000601:surgery; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D013122:Spinal Diseases / Q000000981:diagnostic imaging / Q000601:surgery*; D013123:Spinal Fusion / Q000295:instrumentation*; D025321:Surgery, Computer-Assisted / Q000295:instrumentation*; D013904:Thoracic Vertebrae / Q000000981:diagnostic imaging / Q000601:surgery; D014057:Tomography, X-Ray Computed / Q000295:instrumentation*; D014584:User-Computer Interface
Genauigkeit der fluoroskopischen Navigation von Pedikelschrauben. CT-basierte Evaluierung der Schraubenlage.