[Clinical contrast of cervical pedicle screw fixation assisted by C-arm fluoroscopy or 3D navigation system].
OBJECTIVE
To evaluate the feasibility and accuracy of cervical (C(2)-C(7)) pedicle screw fixation assisted by C-arm fluoroscopy or 3D navigation system (CT-based navigation system or Iso-C 3D navigation system).


METHODS
One hundred and forty-five cervical pedicle screws inserted with C-arm fluoroscopy and 187 pedicle screws inserted with 3D navigation system were observed by postoperative CT or Iso-C 3D scan. The process of navigation was investigated.


RESULTS
In the 145 screws inserted with C-arm fluoroscopy, 133 screws are accurate (91.7%), and in the 187 screws inserted by 3D navigation system, 183 screws are accurate (97.9%) (chi2 = 6.705, P = 0.010), and the 4 misplaced screws occurred in the early stage of navigation system application. The process of navigation was investigated in twenty-five patients. With CT-based navigation, the mean time for registration and surface matching was 3.5 minutes; with Iso-C 3D navigation, the mean time for images collection and transfer was 6.2 minutes. The mean time for screw-marker insertion was 2 minutes.


CONCLUSIONS
3D navigation system can increase accuracy of cervical pedicle screw fixation obviously.
Tian
Wei
W
Department of Spine Surgery, Beijing Jishuitan Hospital, Beijing 100035, China. tianweia@163bj.com
Liu
Ya-jun
YJ
Liu
Bo
B
Li
Qin
Q
Hu
Lin
L
Li
Zhi-yu
ZY
Yuan
Qiang
Q
D000328:Adult; D000368:Aged; D001863:Bone Screws; D002574:Cervical Vertebrae / Q000601:surgery*; D005260:Female; D005471:Fluoroscopy; D005593:Fracture Fixation, Internal / Q000379:methods*; D006801:Humans; D021621:Imaging, Three-Dimensional; D008297:Male; D008875:Middle Aged; D025321:Surgery, Computer-Assisted; D055815:Young Adult