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Intraoperative CT navigation in spinal and pelvic surgery: initial experience

Publication at Third Faculty of Medicine |
2013

Abstract

Introduction: The authors describe their first experience with virtually navigated pelvic and spine screws based on perioperative CT navigation. Material and methods: From 22 October 2012 (launching the device) to 9 January 2013, a total of 15 CT-navigated pelvic and spi- ne operations were performed in 14 patients.

Nerve root compression, scoliosis, vertebral fracture and spondylodiscitis were the indica- tions for spine procedures; B-type and C-type fractures according to the AO classification were the indications in pelvic surgical proce- dures. The preparation and the course of the procedures were in accordance with current standards and recommendations in all the ca- ses.

Perioperative navigation and subsequent examination of the screw trajectory were performed via O-arm imaging system (Medtro- nic Navigation, Louisville, Colorado) instead of the standard C-arm fluoroscopy. Results: A total of 73 screws were inserted (60 transpedicular screws into cervical, thoracic and lumbar vertebrae, 9 iliosacral screws into the first sacral vertebra and 4 pubic screws).

Only one of the pubic screws (1.4% of all screws) was found malpositioned at the subsequent perioperative examination and was extracted immediately and replaced. Further complications were not observed and none of the procedures had to be converted into a standard fluoroscopy guided operation