An experimental study of computer navigation and c-arm fluoroscopy for pedicle screw placement in lower cervical spine
WU Deng-jiang1 YANG Jin-shun2 CHEN Wei-jian1
1.Department of Orthopaedics,the Fifth Affiliated Hospital of Guangzhou Medical University,Guangdong Province,Guangzhou 510700,China;2.Department of Orthopaedics,the Second Affiliated Hospital of Guangzhou Medical University,Guangdong Province,Guangzhou 510260,China
Abstract：ObjectiveTo compare the accuracy of intraoperative computer navigation and ordinary C-arm fluoroscopy in the placement of lower cervical pedicle screws.MethodsAltogether 16 formalin-soaked adult cervical specimens(C1-T1)that were provided by Teaching and Research Section of Anatomy in our school from June 2013 to June 2016 were selected.The integrity of the posterior and lateral structure was required to be retained.CT scan was used to exclude specimens with osteoporosis and small pedicle screw structure that were unable to perform screw placement.The specimens were randomly divided into two groups,among which a group of specimens were placed in the C2-C7entity under the positive lateral fluoroscopy of the normal C-arm machine;and another group of specimens were inserted into the pedicle screw under the guidance of intraoperative computer navigation.The CT scan and 3D reconstruction of the vertebral pedicle were performed to evaluate the accuracy of the screw placement.ResultsAltogether 96 screws were implanted under the fluoroscopy of C-arm，among which 60(62.5%)were excellent,20(20.8%)were good,16(16.7%)were bad.And 96 screws were implanted by using computer navigation,among which 88(91.7%)were excellent,6(6.2%)were good,2 (2.1%)were bad.The success rate of two kinds of cervical screw insertion methods was compared (83.3%vs.97.9%),with statistically significant difference(P＜0.05).ConclusionCompared with the conventional C-arm fluoroscopy,the accuracy of screw placement by using computer navigation is obviously improved.
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