Journal of Korean Neurosurgical Society

The Korean Neurosurgical Society (대한신경외과학회)
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Accuracy of Pedicle Screw Insertion Using Fluoroscopy-Based Navigation-Assisted Surgery : Computed Tomography Postoperative Assessment in 96 Consecutive Patients

  • Lee, Keong Duk (Department of Neurosurgery, Ulsan University Hospital) ;
  • Lyo, In Uk (Department of Neurosurgery, Ulsan University Hospital) ;
  • Kang, Byeong Seong (Department of Radiology, Ulsan University Hospital) ;
  • Sim, Hong Bo (Department of Neurosurgery, Ulsan University Hospital) ;
  • Kwon, Soon Chan (Department of Neurosurgery, Ulsan University Hospital) ;
  • Park, Eun Suk (Department of Neurosurgery, Ulsan University Hospital)
  • Received : 2014.01.23
  • Accepted : 2014.07.15
  • Published : 2014.07.28
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Abstract

Objective : Two-dimensional fluoroscopy-based computerized navigation for the placement of pedicle screws offers the advantage of using stored patient-specific imaging data in providing real-time guidance during screw placement. The study aimed to describe the accuracy and reliability of a fluoroscopy-based navigation system for pedicle screw insertion. Methods : A total of 477 pedicle screws were inserted in the lower back of 96 consecutive patients between October 2007 and June 2012 using fluoroscopy-based computer-assisted surgery. The accuracy of screw placement was evaluated using a sophisticated computed tomography protocol. Results : Of the 477 pedicle screws, 461 (96.7%) were judged to be inserted correctly. Frank screw misplacement [16 screws (3.3%)] was observed in 15 patients. Of these, 8 were classified as minimally misplaced (${\leq}2mm$); 3, as moderately misplaced (2.1-4 mm); and 5, as severely misplaced (>4 mm). No complications, including nerve root injury, cerebrospinal fluid leakage, or internal organ injury, were observed in any of the patients. Conclusion : The accuracy of pedicle screw placement using a fluoroscopy-based computer navigation system was observed to be superior to that obtained with conventional techniques.

Keywords

References

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