Application of intraoperative O-arm-assisted real-time navigation technique for spinal fixation

• 作者: Dan Yuan Dongkang Liu Feng Yang Guihuai Wang Guoqin Wang Huifang Zhang James Wang Linkai Jing Peihai Zhang Peng Chen Wei Shi Yaxing Sun Yi Guo Youtu Wu Zhanquan Zhang Zhenxing Sun
• 来源期刊: 临床转化神经医学(英文版)
• 学科: 医学
• 年，卷（期）: 2017,（3）
• 页码范围: 135-146
• 页数: 2页
• 分类号: R687.3

摘要

This study explored the combined use of the O-arm and real-time navigation during spinal fixation. The clinical data for 60 patients undergoing spinal fixation, at Beijing Tsinghua Chang Gung Hospital between May 5, 2015 and May 1, 2017, were retrospectively analyzed. Pre-, intra-, and postoperative imaging findings were assessed. The patients were classified into the occipitocervical fusion(32 cases) and thoracic/lumbar/sacral spine fixation(28 cases, including 6 cases of percutaneous pedicle screw) groups. Lesion resections were performed microscopically. An O-arm, combined with real-time navigation, was used to assess spinal fixation. Efficacy was evaluated using operative times, X-ray times, screw positioning, and complications. Within the occipitocervical fusion group, 182 screws were placed in the cervical spine and 96 in the occipital bone. However, 6 screws penetrated the bone cortex and were adjacent to the vertebral arteries, based on O-arm three-dimensional imaging; therefore, the precision rate was 96.7%. Within the thoracic/lumbar/sacral spine fixation group, 148 pedicle screws were implanted, with 4 initially outside the vertebral body,yielding a precision rate of 97.3%. Ten percutaneous pedicle screws were implanted and well positioned. O-arm scans were performed 3 times/patient, with an average of 20–30 min/time. Screw implantation times were 5–7 min(cervical spine), 8–10 min(thoracic spine), and 6–8 min(lumbar spine). Intraoperative O-arm scans, combined with real-time navigation technology, allow real-time observation of screw angles and depths, improving the accuracy and safety of posterior screw fixations and reducing the radiation dose and frequency experienced by patients and surgeons.