title: [Intraoperative three-dimensional navigation for pedicle screw placement].
abstract: The mobile SIREMOBIL Iso-C(3D) C-arm (Siemens, Erlangen, Germany) is the first device permitting intraoperative, three-dimensional representation of bone structures. A high-resolution, isotropic 3D data cube in the isocenter with sides of approximately 12 cm is calculated simultaneously. The SIREMOBIL Iso-C(3D) is linked to the navigation system. This makes it possible to transfer the generated 3D data directly to the linked navigation system without the need for surgeon-dependent registration. In this prospective clinical trial, we evaluated the accuracy of pedicle screw placement using this device. In 61 patients, a total of 302 pedicle screws were placed. Only in five cases (1.7%) were misplacements of > or =2 mm shown in postoperative control CT. The average fluoroscopy time was 1.28+/-0.56 min, and the average operative duration was 103.26+/-23.3 min. There were no postoperative neurological complications in any of the 30 patients. From these data, we conclude that Iso-C(3D) navigation is a very accurate method for the placement of pedicle screws.
authors.affiliation: Berufsgenossenschaftliche Unfallklinik Ludwigshafen, Klinik für Unfall- und Wiederherstellungschirurgie an der Universität Heidelberg.
authors.forename: P A
authors.initials: PA
authors.lastname: Grützner
authors.forename: T
authors.initials: T
authors.lastname: Beutler
authors.forename: K
authors.initials: K
authors.lastname: Wendl
authors.forename: J
authors.initials: J
authors.lastname: von Recum
authors.forename: A
authors.initials: A
authors.lastname: Wentzensen
authors.forename: L-P
authors.initials: LP
authors.lastname: Nolte
mesh_terms: D000293:Adolescent; D000368:Aged; D000369:Aged, 80 and over; D001863:Bone Screws; D005260:Female; D005471:Fluoroscopy; D005593:Fracture Fixation, Internal / Q000295:instrumentation*; D006801:Humans; D021621:Imaging, Three-Dimensional; D008159:Lumbar Vertebrae / Q000293:injuries; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D016103:Spinal Fractures / Q000601:surgery*; D025321:Surgery, Computer-Assisted / Q000295:instrumentation; D013904:Thoracic Vertebrae / Q000293:injuries; D014057:Tomography, X-Ray Computed
vernacular_title: Navigation an der Brust- und Lendenwirbelsäule mit dem 3D-Bildwandler.