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KMID : 1189320140080030331
Asian Spine Journal
2014 Volume.8 No. 3 p.331 ~ p.338
Accuracy of Pedicle Screw Placement in Scoliosis Surgery: A Comparison between Conventional Computed Tomography-Based and O-Arm-Based Navigation Techniques
Kotani Toshiaki

Akazawa Tsutomu
Sakuma Tsuyoshi
Koyama Kayo
Nemoto Tetsuharu
Nawata Kento
Yamazaki Atsuro
Minami Shohei
Abstract
Study Design: Retrospective study.

Purpose: We compared the accuracy of O-arm-based navigation with computed tomography (CT)-based navigation in scoliotic surgery.

Overview of Literature: No previous reports comparing the results of O-arm-based navigation with conventional CT-based navigation in scoliotic surgery have been published.

Methods: A total of 222 pedicle screws were implanted in 29 patients using CT-based navigation (group C) and 416 screws were implanted in 32 patients using O-arm-based navigation (group O). Postoperative CT was performed to assess the screw accuracy, using the established Neo classification (grade 0: no perforation, grade 1: perforation <2 mm, grade 2: perforation ¡Ã2 and <4, and grade 3: perforation ¡Ã4 mm).

Results: In group C, 188 (84.7%) of the 222 pedicle screw placements were categorized as grade 0, 23 (10.4%) were grade 1, 11 (5.0%) were grade 2, and 0 were grade 3. In group O, 351 (84.4%) of the 416 pedicle screw placements were categorized as grade 0, 52 (12.5%) were grade 1, 13 (3.1%) were grade 2, and 0 were grade 3. Statistical analysis showed no significant difference in the prevalence of grade 2.3 perforations between groups C and O. The time to position one screw, including registration, was 10.9¡¾3.2 minutes in group C, but was significantly decreased to 5.4¡¾1.1 minutes in group O.

Conclusions: O-arm-based navigation facilitates pedicle screw insertion as accurately as conventional CT-based navigation. The use of O-arm-based navigation successfully reduced the time, demonstrating advantages in the safety and accuracy of pedicle screw placement for scoliotic surgery.
KEYWORD
Scoliosis, Computer-assisted surgery, Image-guided surgery, Spine
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