title: Accuracy of screw placement and radiation dose in navigated dorsal instrumentation of the cervical spine: a prospective cohort study.
abstract: BACKGROUND
  Dorsal cervical spinal fusion is a challenging procedure in fracture fixation. There is limited information in the literature about computer navigation using lateral mass screws in cases of spinal trauma.
  
  
  METHODS
  Retrospective analysis of a prospective database covering an 8 year period. All patients who received a dorsal spinal fusion due to a fracture of the cervical spine were included. Outcome parameters were screw accuracy, duration of surgery, the radiation emitted and intra-/postoperative complications.
  
  
  RESULTS
  Sixteen patients, who received 67 screws (44 navigated vs 23 conventionally inserted screws) were included. Three-dimensional (3D)-based computer navigation prolonged the duration of surgery but helped to reduce the radiation emitted and led to significantly increased accuracy of screw positioning.
  
  
  CONCLUSIONS
  Computer navigation can increase the accuracy of lateral mass screws in spinal trauma. It prolongs the surgical procedure but reduces the emission of radiation significantly.
authors.affiliation: Hessing Foundation, Hospital for Reconstructive and Spine Surgery, Augsburg, Germany; Ulm University, Institute of Research in Rehabilitation Medicine, Bad Buchau, Germany.
authors.forename: Michael
authors.initials: M
authors.lastname: Kraus
authors.forename: Stephanie
authors.initials: S
authors.lastname: von dem Berge
authors.forename: Mario
authors.initials: M
authors.lastname: Perl
authors.forename: Gert
authors.initials: G
authors.lastname: Krischak
authors.forename: Sebastian
authors.initials: S
authors.lastname: Weckbach
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001863:Bone Screws; D002574:Cervical Vertebrae / Q000000981:diagnostic imaging / Q000293:injuries* / Q000601:surgery*; D015331:Cohort Studies; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D011446:Prospective Studies; D011829:Radiation Dosage; D011859:Radiography; D016103:Spinal Fractures / Q000000981:diagnostic imaging / Q000601:surgery*; D013123:Spinal Fusion / Q000379:methods*; D025321:Surgery, Computer-Assisted / Q000379:methods*
keywords: cervical spine; computer navigation; lateral mass screw; spinal trauma