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http://dx.doi.org/10.3340/jkns.2014.56.1.16

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)
Publication Information
Journal of Korean Neurosurgical Society / v.56, no.1, 2014 , pp. 16-20 More about this Journal
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
Accuracy; Pedicle screw; Fluoroscopy-based navigator;
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