title: Placement of thoracolumbar pedicle screws using O-arm-based navigation: technical note on controlling the operational accuracy of the navigation system.
abstract: Suboptimal placements of pedicle screws may lead to neurological and vascular complications. Computer-assisted image guidance has been shown to improve accuracy in spinal instrumentation. Checking the accuracy of the navigation system during pedicle screw placement is fundamental. We describe a novel technique of using continuous accuracy check of the navigation system during O-arm-based neuronavigation to instrument the thoracolumbar region. Forty thoracic and 42 lumbar screws were inserted in 12 patients. The Mirza evaluation system was used to evaluate the accuracy of the inserted screws. There was no neurological injury and no need to reposition any screw. The accuracy of the screws placement was excellent. Our technique of continuous at will operational accuracy check of the neuronavigation system is associated with extreme accuracy of screw placement, no need to bring a patient back to the operating room to reposition a pedicle screw, and with excellent outcome.
authors.affiliation: Department of Neurological Surgery, Ohio State University Medical Center, N1025 Doan Hall, 410 W. 10th Avenue, Columbus, OH 43210, USA. mario.ammirati@osumc.edu
authors.forename: Mario
authors.initials: M
authors.lastname: Ammirati
authors.forename: Asem
authors.initials: A
authors.lastname: Salma
mesh_terms: D001863:Bone Screws; D005471:Fluoroscopy; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008159:Lumbar Vertebrae / Q000033:anatomy & histology / Q000601:surgery*; D008161:Lumbosacral Region; D038361:Neuronavigation / Q000379:methods*; D019635:Neurosurgical Procedures / Q000379:methods*; D012086:Reoperation / Q000706:statistics & numerical data; D015203:Reproducibility of Results; D025321:Surgery, Computer-Assisted / Q000379:methods*; D013904:Thoracic Vertebrae / Q000033:anatomy & histology / Q000601:surgery*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome