[Accuracy of CT-based navigation of pedicle screws implantation in the cervical spine compared with X-ray fluoroscopy technique].
OBJECTIVE
To evaluate the feasibility and accuracy of cervical spine pedicle screw fixation assisted by X-ray fluoroscopy and CT-based navigation system.


METHODS
145 cervical pedicle screws were placed assisted by X-ray fluoroscopy and 159 cervical pedicle screws were placed assisted by CT-based navigation system. Screw positions were evaluated by postoperative CT scans or C-arm X-ray 3 dimensional reconstruction.


RESULTS
In the computer- assisted group, 155 (97.5%) screws were found completely within their pedicles compared with 133 (91.7%) correctly placed screws in the X-ray assisted group (P < 0.05). The process of navigation investigated in twenty patients showed that the mean time for registration and surface matching was 3.5 (range from 2 to 8 minutes) minutes and the mean time for screw-marker insertion was 2 (range from 1 to 3.5 minutes) minutes with the mean position deviation 0.31 mm (0.12-0.56 mm) per screw. Only twice C-arm fluoroscopy were performed to verify the accuracy of one screw position intraoperatively. No severe complications like neurovascular lesion occurred in both groups.


CONCLUSIONS
CT-based navigation system can increase the accuracy of cervical pedicle screw implantation significantly.
Liu
Ya-jun
YJ
Department of Spine Surgery, Beijing Jishuitan Hospital, Beijing 100035, China.
Tian
Wei
W
Liu
Bo
B
Li
Qin
Q
Hu
Lin
L
Li
Zhi-yu
ZY
Yuan
Qiang
Q
Xing
Yong-gang
YG
Wang
Yong-qing
YQ
Sun
Yu-zhen
YZ
D000328:Adult; D001863:Bone Screws; D002574:Cervical Vertebrae / Q000000981:diagnostic imaging / Q000601:surgery; D005260:Female; D005471:Fluoroscopy; D006801:Humans; D021621:Imaging, Three-Dimensional; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013123:Spinal Fusion / Q000379:methods*; D025321:Surgery, Computer-Assisted; D014057:Tomography, X-Ray Computed / Q000379:methods