The Use of Neuronavigation and Intraoperative Imaging in Spinal Stabilization Surgery

This system protects the surgical team from fluoroscopic radiation exposure and the patient from the complications of screw misplacement and repeated surgeries.

📌 3 Key Takeaways

🎯

Objective & Hypothesis:AIM: Misplacement of pedicle screw is the serious complication of spinal surgeries.

📊

Key Findings & Data:MATERIAL and METhODS: Between 2011 and 2014, one hundred and two patients underwent instrumented spinal surgery while using intraoperative computed tomography (iCT) and a navigation system.

💡

Conclusion & Impact:This system protects the surgical team from fluoroscopic radiation exposure and the patient from the complications of screw misplacement and repeated surgeries.

🔬Design:Research Article

📍Scope:2011 Verileri

⚙️Variables:Domain Parameters

Özet

AIM: Misplacement of pedicle screw is the serious complication of spinal surgeries. Intraoperative imaging techniques and navigation systems are currently in use for the prevention of this complication. The aim of this study was to document the results of our experience with the navigation and intraoperative imaging technique and to share our experience with our colleagues. MATERIAL and METhODS: Between 2011 and 2014, one hundred and two patients underwent instrumented spinal surgery while using intraoperative computed tomography (iCT) and a navigation system. All patients had a CT scan performed no more than three days postoperatively to confirm adequate placement of the screws. The accuracy of pedicle screw placement was assessed by postoperative CT scan. Pedicle violations were graded according to an established classification system. RESULTS: In the 36-month period, a total of 610 screws in 102 patients were evaluated. Stabilization surgery was performed in the lumbosacral region in 51 (50%) patients, lumbar region in 35 (34.31%) patients, cervical region in 5 (4.9%) patients, thoracolumbar region in 7 (6.86%) patients and thoracic region in 4 (3.92%) patients. Of the 610 screws, 396 (64.91%) were placed in lumbar, 66 (10.81%) in thoracic, 106 (17.37%) in sacral and 42 (6.8%) in cervical vertebrae. Of the 610 screws, 599 screws (98.18%) were placed without a breach. Grade 1 breaches occurred in 8 screws (1.31%), Grade 2 breaches occurred in 2 screws (0.32%), and Grade 3 breaches in 1 screw (0.16%). No dural defect or neurological deficit occurred after the surgeries. CONCLUSION: The use of an iCT scan associated with a navigation system increases the accuracy of pedicle screw placement. This system protects the surgical team from fluoroscopic radiation exposure and the patient from the complications of screw misplacement and repeated surgeries.

🔖

Cite This Article

TEHLİ, Ö., HARMAN, F., TEMİZ, Ç., KACAR, Y., KAZANCI, B., DANEYEMEZ, M., SOLMAZ, İ., KURAL, C. (2016). The Use of Neuronavigation and Intraoperative Imaging in Spinal Stabilization Surgery. Turkish Neurosurgery, Cilt: 26 - Sayı: 5, 771–776. https://ajindex.com/articles/404725

📄 Full Text PDF Viewer

Open in New Tab ↗

↗New Tab

📄

PDF görüntüleyici hazırlanıyor...

References (1)

Abdullah KG, Bishop FS, Lubelski D, Steinmetz MP, Benzel EC, Mroz TE: Radiation exposure to the spine surgeon in lumbar and thoracolumbar fusions with the use of an intraoperative computed tomographic 3-dimensional imaging system. Spine 37:E1074-1078, 2012 2. Abul-Kasim K, Ohlin A, Strömbeck A, Maly P, Sundgren PC: Radiological and clinical outcome of screw placement in adolescent idiopathic scoliosis: Evaluation with low-dose computed tomography. Eur Spine J 19:96-104, 2010 3. Carl AL, Khanuja HS, Gatto CA, Matsumoto M, vomLehn J, Schenck J, Rohling K, Lorensen W, Vosburgh K: In vivo pedicle screw placement: Image-guided virtual vision. J Spinal Disord 13:225-229, 2000 4. Costa F, Cardia A, Ortolina A, Fabio G, Zerbi A, Fornari M: Spinal navigation: Standard preoperative versus intraoperative computed tomography data set acquisition for computerguidance system: Radiological and clinical study in 100 consecutive patients. Spine 36:2094-2098, 2011 5. Dinesh SK, Tiruchelvarayan R, Ng I: A prospective study on the use of intraoperative computed tomography (iCT) for image-guided placement of thoracic pedicle screws. Br J Neurosurgery 26:838-844, 2012 6. Ferguson RL, Tencer AF, Woodard P, Allen BL Jr: Biomechanical comparisons of spinal fracture models and the stabilizing effects of posterior instrumentations. Spine 13:453-460, 1988 7. Hecht AC, Koehler SM, Laudone JC, Jenkins A, Qureshi S: Is intraoperative CT of posterior cervical spine instrumentation cost-effective and does it reduce complications? Clin Orthop Relat Res 469:1035-1041, 2011 8. Houten JK, Nasser R, Baxi N: Clinical assessment of percutaneous lumbar pedicle screw placement using the O-arm multidimensional surgical imaging system. Neurosurgery 70: 990-995, 2012 9. Izci Y, Taskaynatan MA: Management of lower back pain in young Turkish recruits. Mil Med 169(10):824-828, 2004 10. Laine T, Lund T, Ylikoski M, Lohikoski J, Schlenzka D: Accuracy of pedicle screw insertion with and without computer assistance: A randomised controlled clinical study in 100 consecutive patients. Eur Spine J 9:235-240, 2000 11. Laine T, Mäkitalo K, Schlenzka D, Tallroth K, Poussa M, Alho A: Accuracy of pedicle screw insertion: A prospective CT study in 30 low back patients. Eur Spine J 6:402-405, 1997 12. Larson AN, Santos ER, Polly DW Jr, Ledonio CG, Sembrano JN, Mielke CH, Guidera KJ: Pediatric pedicle screw placement using intraoperative computed tomography and 3-dimensional image-guided navigation. Spine 37:E188-1