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Spinal Navigation for Cervical Pedicle Screws: Surgical Pearls and Pitfalls
| Content Provider | SAGE Publishing |
|---|---|
| Author | Gan, Gerrard Kaliya-Perumal, Arun-Kumar Yu, Chun Sing Nolan, Colum Patrick Oh, Jacob Yoong-Leong |
| Copyright Year | 2020 |
| Abstract | Study Design:Retrospective cohort study.Objective:We intend to evaluate the accuracy and safety of cervical pedicle screw (CPS) insertion under O-arm-based 3-dimensional (3D) navigation guidance.Methods:This is a retrospective study of patients who underwent CPS insertion under intraoperative O-arm-based 3D navigation during the years 2009 to 2018. The radiological accuracy of CPS placement was evaluated using their intraoperative scans.Results:A total of 297 CPSs were inserted under navigation. According to Gertzbein classification, 229 screws (77.1%) were placed without any pedicle breach (grade 0). Of the screws that did breach the pedicle, 51 screws (17.2%) had a minor breach of less than 2 mm (grade 1), 13 screws (4.4%) had a breach of between 2 and 4 mm (grade 2), and 4 screws (1.3%) had a complete breach of 4 mm or more (grade 3). Six screws were revised intraoperatively. There was no incidence of neurovascular injury in this series of patients. 59 of the 68 breaches (86.8%) were found to perforate laterally, and the remaining 9 (13.2%) medially. It was noted that the C5 cervical level had the highest breach rate of 33.3%.Conclusions:O-arm-based 3D navigation can improve the accuracy and safety of CPS insertion. The overall breach rate in this study was 22.9%. Despite these breaches, there was no incidence of neurovascular injury or need for revision surgery for screw malposition. |
| Related Links | https://journals.sagepub.com/doi/pdf/10.1177/2192568220902093?download=true |
| Starting Page | 196 |
| Ending Page | 202 |
| Page Count | 7 |
| ISSN | 21925682 |
| Issue Number | 2 |
| Volume Number | 11 |
| Journal | Global Spine Journal (GSJ) |
| e-ISSN | 21925690 |
| DOI | 10.1177/2192568220902093 |
| Language | English |
| Publisher | Sage Publications CA |
| Publisher Date | 2020-01-27 |
| Publisher Place | Los Angeles |
| Access Restriction | Open |
| Rights Holder | © The Author(s) 2020 |
| Subject Keyword | computer-assisted surgery intraoperative complications equipment safety neuronavigation pedicle screws |
| Content Type | Text |
| Resource Type | Article |
| Subject | Orthopedics and Sports Medicine Neurology (clinical) Surgery |
