Safety of screw placement for severe spinal deformity with the use of O-arm three-dimensional computer-assisted navigation system

doi:10.3969/j.issn.2095-4344.2016.26.008

Abstract

Abstract:

BACKGROUND: O-arm navigation integrates CT image quality and the flexible mobility of the C-arm. Surgery for severe spinal deformity is very difficult, with high incidence of nerve injury, so it is a challenging surgery for spinal surgery. The role of O-arm in the correction of spinal deformity is particularly important.

OBJECTIVE: To explore the effect and safety of pedicle screw placement in severe spinal deformity under the guidance of O-arm navigation system.

METHODS: Clinical data of 25 patients with severe spinal deformity with the aid of O-arm navigation were retrospectively analyzed. We observed pedicle screw insertion, operation time, intraoperative blood loss, correction of scoliosis and correction of kyphosis, and assessed the safety of screw insertion.

RESULTS AND CONCLUSION: (1) Totally 326 pedicle screws were implanted in 25 patients. According to NEO classification, 280 pedicle screws (92%) belonged to grade 0 (no perforation of pedicle cortex). Grade 1: perforation of pedicle cortex, < 2 mm, including 44 screws (8%); grade 2: perforation of pedicle cortex, > 2 mm, < 4 mm, including 0 screw (0%); grade 3: perforation of pedicle cortex, > 4 mm, including 0 screw (0%). (2) Operation time was (272.3±17.3) minutes. Intraoperative blood loss was (1 710.0±229.1) mL. (3) Cobb angle of scoliosis was changed from (70.5±6.0)° preoperatively to (22.8±4.8)° postoperatively. Cobb angle of kyphosis was changed from (72.0±5.2)° preoperatively to (28.1±5.7)° postoperatively. Significant differences were detected (P < 0.05). (4) These findings verify that with the guide of the O-arm navigation system, the accuracy of screw insertion is high. The risk of intraoperative nerve injury was reduced. The scoliosis and kyphosis deformity were improved effectively.

中国组织工程研究杂志出版内容重点：人工关节；骨植入物；脊柱；骨折；内固定；数字化骨科；组织工程

Key words: Scoliosis, Kyphosis, Bone Nails, Tissue Engineering

CLC Number:

R318

Wang Tao, Wang Hui, Song Yan-li, Yang Da-long, Wei Hai-kun, Liu Feng-yu, Ding Wen-yuan. Safety of screw placement for severe spinal deformity with the use of O-arm three-dimensional computer-assisted navigation system[J]. Chinese Journal of Tissue Engineering Research, 2016, 20(26): 3849-3855.

Figures/Tables 3

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