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European Journal of Trauma and Emergency Surgery

Erschienen in:

01.04.2011 | Review Article

3D-based navigation in posterior stabilisations of the cervical and thoracic spine: problems and benefits. Results of 451 screws

verfasst von: J.-S. Jarvers, S. Katscher, A. Franck, S. Glasmacher, C. Schmidt, T. Blattert, C. Josten

Erschienen in: European Journal of Trauma and Emergency Surgery | Ausgabe 2/2011

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Abstract

Introduction

Navigated procedures in spinal surgery have been established due to an increasing demand for precision. Especially, 3D C-arms connected to navigation systems are being used more often and can be utilised intraoperatively for the planning and controlling of screw positions. This prospective study analyses our experiences with 3D-based navigation in posterior stabilisations in the cervical and thoracic spine.

Methods

A 3D C-Arm (Ziehm Vision Vario 3D^®) was connected to a navigation system (VectorVision, Brainlab^®) and used for the placement of, in total, 451 screws among 67 patients. Of those, 14 patients had to undergo operations in the cervical and 53 in the thoracic spine. Postoperatively, the positioning was observed with computed tomography (CT).

Results

The application time is approximately 6 min. In total, 354/451 (78.5%) screws could be inserted assisted with navigation, and 272/451 (60.3%) were controlled intraoperatively. Regarding the cervical spine, in 87.1% (61/70) of the screws, the navigation procedure was uneventful. The positioning of 63.2% (43/68) of the screws was checked intraoperatively. In the upper thoracic spine, 77% (293/381) could be placed with navigation and 59.6% (227/381) were controlled intraoperatively. Occasionally, the scanning setup was problematic. Correct placement was seen in 92.7% of screws; for the remaining screws, no revision was needed.

Conclusions

Intraoperative 3D imaging navigation for posterior spinal stabilisations is technically feasible and reliable in clinical use. The image quality depends on the individual bone density. With undisturbed visibility of the vertebral body, the reliability of 3D-based navigation is comparable to that of CT-based procedures. Additionally, it has the advantage of skipping the preoperative acquisition of data as well as the matching process, with reduced radiation doses.

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Titel: 3D-based navigation in posterior stabilisations of the cervical and thoracic spine: problems and benefits. Results of 451 screws
verfasst von: J.-S. Jarvers
S. Katscher
A. Franck
S. Glasmacher
C. Schmidt
T. Blattert
C. Josten
Publikationsdatum: 01.04.2011
Verlag: Springer-Verlag
Erschienen in: European Journal of Trauma and Emergency Surgery / Ausgabe 2/2011
Print ISSN: 1863-9933
Elektronische ISSN: 1863-9941
DOI: https://doi.org/10.1007/s00068-011-0098-1

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Springer Medizin

3D-based navigation in posterior stabilisations of the cervical and thoracic spine: problems and benefits. Results of 451 screws

Abstract

Introduction

Methods

Results

Conclusions

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Springer Medizin

Abstract

Introduction

Methods

Results

Conclusions

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