title: Accuracy of Pedicle Screw Placement in Scoliosis Surgery: A Comparison between Conventional Computed Tomography-Based and O-Arm-Based Navigation Techniques.
abstract: METHODS
  Retrospective study.
  
  
  OBJECTIVE
  We compared the accuracy of O-arm-based navigation with computed tomography (CT)-based navigation in scoliotic surgery.
  
  
  BACKGROUND
  No previous reports comparing the results of O-arm-based navigation with conventional CT-based navigation in scoliotic surgery have been published.
  
  
  METHODS
  A total of 222 pedicle screws were implanted in 29 patients using CT-based navigation (group C) and 416 screws were implanted in 32 patients using O-arm-based navigation (group O). Postoperative CT was performed to assess the screw accuracy, using the established Neo classification (grade 0: no perforation, grade 1: perforation <2 mm, grade 2: perforation ≥2 and <4, and grade 3: perforation ≥4 mm).
  
  
  RESULTS
  In group C, 188 (84.7%) of the 222 pedicle screw placements were categorized as grade 0, 23 (10.4%) were grade 1, 11 (5.0%) were grade 2, and 0 were grade 3. In group O, 351 (84.4%) of the 416 pedicle screw placements were categorized as grade 0, 52 (12.5%) were grade 1, 13 (3.1%) were grade 2, and 0 were grade 3. Statistical analysis showed no significant difference in the prevalence of grade 2.3 perforations between groups C and O. The time to position one screw, including registration, was 10.9±3.2 minutes in group C, but was significantly decreased to 5.4±1.1 minutes in group O.
  
  
  CONCLUSIONS
  O-arm-based navigation facilitates pedicle screw insertion as accurately as conventional CT-based navigation. The use of O-arm-based navigation successfully reduced the time, demonstrating advantages in the safety and accuracy of pedicle screw placement for scoliotic surgery.
authors: Department of Orthopedic Surgery, Seirei Sakura Citizen Hospital, Sakura, Japan.
authors: Toshiaki
authors: T
authors: Kotani
authors: Department of Orthopedic Surgery, Seirei Sakura Citizen Hospital, Sakura, Japan.
authors: Tsutomu
authors: T
authors: Akazawa
authors: Department of Orthopedic Surgery, Seirei Sakura Citizen Hospital, Sakura, Japan.
authors: Tsuyoshi
authors: T
authors: Sakuma
authors: Department of Clinical Engineering, Seirei Sakura Citizen Hospital, Sakura, Japan.
authors: Kayo
authors: K
authors: Koyama
authors: Department of Orthopedic Surgery, Seirei Sakura Citizen Hospital, Sakura, Japan.
authors: Tetsuharu
authors: T
authors: Nemoto
authors: Department of Orthopedic Surgery, Seirei Sakura Citizen Hospital, Sakura, Japan.
authors: Kento
authors: K
authors: Nawata
authors: Department of Orthopedic Surgery, Seirei Sakura Citizen Hospital, Sakura, Japan.
authors: Atsuro
authors: A
authors: Yamazaki
authors: Department of Orthopedic Surgery, Seirei Sakura Citizen Hospital, Sakura, Japan.
authors: Shohei
authors: S
authors: Minami
keywords: Computer-assisted surgery; Image-guided surgery; Scoliosis; Spine