To explore the applicability and precision of O-arm combined with real-time navigation technique in spinal fixation.

The clinical data of 31 inpatients with spinal fixation were retrospectively analyzed at Department of Neurosurgery, Beijing Tsinghua ChangGung Hospital from May 2015 to May 2016. Preoperative, intraoperative and postoperative imaging findings were assessed. The patients were divided into occipitocervical fusion group (19 cases) and thoracic-lumbar-sacral spine fixation group (12 cases). The lesion resection was performed under microscope. O-arm combined with real-time navigation was used in spinal fixation. Surgical efficacy in the patients was evaluated by means of operation time, X-ray times, screw positions and complications.

During the occipitocervical fusion group, 112 screws were implanted in the cervical spine, and 57 in occipital bones. Two screws were found to have penetrated bone cortex and were adjacent to vertebral arteries according to intraoperative 3-D image of O-arm. In the thoracic-lumbar-sacral spine fixation group, 72 pedicle screws were implanted, but 2 screws were out of vertebral body and corrected in time. O-arm scan times was 3 per case on average, and the operation time of O-arm and navigation was 20-30 minutes per time. Screw implantation lasted 5-7 minutes per screw in cervical spine, 8-10 minutes in thoracic and 6-8 minutes in lumbar spine.

Through O-arm real-time navigation, the angle and depth of screws could be observed in real during screw implantation, which would greatly improve the implantation accuracy and safety, and, at the same time, reduce the radiation dose and times for the patients.

Surgery, computer-assisted; O-arm; Spinal fixation; Treatment outcome