title: Navigation of pedicle screws in the thoracic spine with a new electromagnetic navigation system: a human cadaver study.
abstract: BACKGROUND
  Posterior stabilization of the spine is a standard procedure in spinal surgery. In addition to the standard techniques, several new techniques have been developed. The objective of this cadaveric study was to examine the accuracy of a new electromagnetic navigation system for instrumentation of pedicle screws in the spine.
  
  
  METHODS
  Forty-eight pedicle screws were inserted in the thoracic spine of human cadavers using EMF navigation and instruments developed especially for electromagnetic navigation. The screw position was assessed postoperatively by a CT scan.
  
  
  RESULTS
  The screws were classified into 3 groups: grade 1 = ideal position; grade 2 = cortical penetration <2 mm; grade 3 = cortical penetration ≥2 mm. The initial evaluation of the system showed satisfied positioning for the thoracic spine; 37 of 48 screws (77.1%, 95% confidence interval [62.7%, 88%]) were classified as group 1 or 2.
  
  
  CONCLUSIONS
  The screw placement was satisfactory. The initial results show that there is room for improvement with some changes needed. The ease of use and short setup times should be pointed out. Instrumentation is achieved without restricting the operator's mobility during navigation.
  
  
  CONCLUSIONS
  The results indicate a good placement technique for pedicle screws. Big advantages are the easy handling of the system.
authors.affiliation: Center for Spine Surgery and Pain Therapy, Center for Orthopaedics and Traumatology of the St. Elisabeth Group-Catholic Hospitals Rhine-Ruhr, St. Anna Hospital Herne/Marienhospital Herne University Hospital/Marien Hospital Witten, Hospitalstrasse 19, 44649 Herne, Germany.
authors.forename: Patrick
authors.initials: P
authors.lastname: Hahn
authors.affiliation: Center for Spine Surgery and Pain Therapy, Center for Orthopaedics and Traumatology of the St. Elisabeth Group-Catholic Hospitals Rhine-Ruhr, St. Anna Hospital Herne/Marienhospital Herne University Hospital/Marien Hospital Witten, Hospitalstrasse 19, 44649 Herne, Germany.
authors.forename: Semih
authors.initials: S
authors.lastname: Oezdemir
authors.affiliation: Center for Spine Surgery and Pain Therapy, Center for Orthopaedics and Traumatology of the St. Elisabeth Group-Catholic Hospitals Rhine-Ruhr, St. Anna Hospital Herne/Marienhospital Herne University Hospital/Marien Hospital Witten, Hospitalstrasse 19, 44649 Herne, Germany.
authors.forename: Martin
authors.initials: M
authors.lastname: Komp
authors.affiliation: Center for Spine Surgery and Pain Therapy, Center for Orthopaedics and Traumatology of the St. Elisabeth Group-Catholic Hospitals Rhine-Ruhr, St. Anna Hospital Herne/Marienhospital Herne University Hospital/Marien Hospital Witten, Hospitalstrasse 19, 44649 Herne, Germany.
authors.forename: Athanasios
authors.initials: A
authors.lastname: Giannakopoulos
authors.affiliation: Clinic for Orthopaedics and Orthopaedic Surgery, University Medicine of Greifswald, Ferdinand-Sauerbruch-Strasse, 17475 Greifswald, Germany.
authors.forename: Richard
authors.initials: R
authors.lastname: Kasch
authors.affiliation: Clinic for Orthopaedics and Orthopaedic Surgery, University Medicine of Greifswald, Ferdinand-Sauerbruch-Strasse, 17475 Greifswald, Germany.
authors.forename: Harry
authors.initials: H
authors.lastname: Merk
authors.affiliation: Institute for Diagnostic and Interventional Radiology and Nuclear Medicine, Marienhospital Herne, University Hospital of the Ruhr-University Bochum, St. Elisabeth Group-Catholic Hospitals Rhine-Ruhr, Hölkeskampring 40, 44625 Herne, Germany.
authors.forename: Dieter
authors.initials: D
authors.lastname: Liermann
authors.affiliation: Center for Orthopaedics and Traumatology of the St. Elisabeth Group-Catholic Hospitals Rhine-Ruhr, St. Anna Hospital Herne/Marienhospital Herne University Hospital/Marien Hospital Witten, Hospitalstrasse 19, 44649 Herne, Germany.
authors.forename: Georgios
authors.initials: G
authors.lastname: Godolias
authors.affiliation: Center for Spine Surgery and Pain Therapy, Center for Orthopaedics and Traumatology of the St. Elisabeth Group-Catholic Hospitals Rhine-Ruhr, St. Anna Hospital Herne/Marienhospital Herne University Hospital/Marien Hospital Witten, Hospitalstrasse 19, 44649 Herne, Germany.
authors.forename: Sebastian
authors.initials: S
authors.lastname: Ruetten
mesh_terms: D002102:Cadaver; D055590:Electromagnetic Phenomena; D006801:Humans; D008159:Lumbar Vertebrae / Q000601:surgery; D019637:Orthopedic Procedures / Q000379:methods*; D065289:Pedicle Screws; D013123:Spinal Fusion / Q000379:methods; D025321:Surgery, Computer-Assisted / Q000379:methods; D013904:Thoracic Vertebrae / Q000601:surgery*