Accuracy of X-ray fluoroscopy versus CT three-dimensional image navigation in cervical pedicle screw insertion

doi:10.3969/j.issn.2095-4344.2017.11.021

Abstract

Abstract:

BACKGROUND: Navigation systems all can improve the accuracy rate in cervical pedicle screw insertion, but cannot achieve desired outcomes because of some shortcomings, such as poor imaging quality, complicated operation, poor real-time performance, and invasive navigation.

OBJECTIVE: To study the accuracy of X-ray fluoroscopy and CT three-dimensional image navigation in cervical pedicle screw insertion.

METHODS: Totally 90 patients undergoing cervical pedicle screw insertion from the First Affiliated Hospital of Nanyang Medical College were enrolled, and randomly divided into control and experimental groups (n=45 per group). 132 cervical pedicle screws were inserted into the patients in the control group manually under X-ray fluoroscopy, and 128 ones were inserted into the patients in the experimental group assisted with CT three-dimensional image navigation. The operation time and intraoperative blood loss in the two groups were recorded. Postoperative CT three-dimensional reconstruction was performed to compare the placement accuracy between two groups.

RESULTS AND CONCLUSION: The excellent and good rate of placement in the experimental group (95.3%) was significantly higher than that in the control group (88.6%, P < 0.05). (2) The operation time and intraoperative blood loss in the experimental group were significantly higher than those in the control group, and the navigation matching time and radiant quantity in the experimental group were significantly less than those in the control group (P < 0.05). (3) The Japanese Orthopedic Association scores showed no significant difference between two groups before surgery (P > 0.05), and were significantly improved in the experimental group compared with the control group at 3 and 6 months postoperatively (P < 0.05). The incidence of complications in the experimental group was significantly lower than that in the control group (7% versus 16%, P < 0.05). (5) These results suggest that compared with X-ray fluoroscopy, CT three-dimensional image navigation can improve the accuracy of cervical pedicle screw insertion, showing higher safety and precision. However, it needs complicated operation skills, and long operation time results in massive intraoperative blood loss; thereafter, choosing which placement method depends on the patient condition.

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: Cervical Vertebrae, X-Rays, Imaging, Three-Dimensional, Tissue Engineering

CLC Number:

R318

Yu Wei, Wang Lei, He Si-feng, Guo Hong-bin, Liu Dong-sheng. Accuracy of X-ray fluoroscopy versus CT three-dimensional image navigation in cervical pedicle screw insertion [J]. Chinese Journal of Tissue Engineering Research, 2017, 21(11): 1758-1763.

Figures/Tables 2

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