Accuracy of pedicle screw placement in the thoracic and lumbosacral spines using O-arm-based navigation versus conventional freehand technique  

作　　者：Linkai Jing Zhenze Wang Zhenxing Sun Huifang Zhang James Wang Guihuai Wang 

机构地区：[1]School of Clinical Medicine,Tsinghua University,Beijing 100084,China [2]Department of Neurosurgery,Beijing Tsinghua Changgung Hospital,School of Clinical Medicine,Tsinghua University,Beijing 102218,China

出　　处：《Chinese Neurosurgical Journal》2019年第3期137-143,共7页中华神经外科杂志（英文）

基　　金：the National Natural Science Foundation of China(grant 81472817).

摘　　要：The accuracy and safety of pedicle screw insertion was markedly improved with the introduction of intraoperative three-dimensional navigation system during the last decade. This study aimed to evaluate the accuracy of pedicle screw placement using O-arm-based navigation system versus conventional freehand technique. Methods: We reviewed the accuracy of 341 thoracic (n = 173) and lumbosacral (n = 168) pedicle screws placed in 60 consecutive patients using either O-arm-based navigation or freehand technique in the Department of Neurosurgery of Beijing Tsinghua Changgung Hospital between January 2015 and June 2018. Patient-specific characteristics, treatment-related characteristics, and screw-specific accuracy were analyzed. The accuracy of pedicle screw placement was measured by Gertzbein-Robbins scale and screw grades A and B were clinically acceptable. Results: One hundred ninety-one screws were inserted in the O-arm-based navigation group and 150 in the freehand group. One hundred eighty-three (95.81%) clinically acceptable screws were placed in the navigation group and 135 (90.00%) in the freehand group (p = 0.034). Twenty-three (6.74%) screw revisions were performed in the two groups (8 screws in the navigation group and 15 screws in the freehand group) and significant difference was observed in thoracic spine (p = 0.018), while no statistical significance was presented in lumbosacral spine (p >0.05). Twenty-four (12.57%) screws in the navigation group and 24 (16.00%) in the freehand group violated the cortex (p > 0.05). Medial screw deviation was the most common problem in the two groups. Conclusion: The O-arm-based navigation exhibits higher accuracy for pedicle screw insertion than the freehand insertion technique.

关 键 词：ACCURACY FREEHAND NAVIGATION O-arm PEDICLE screw 

分 类 号：R73[医药卫生—肿瘤]