Application of 3D O-arm-navigated pedicle screw insertion in spinal stability reconstruction in patients with spinal cord and spinal column tumors
Linkai Jing, Zhenxing Sun, Yi Guo, Youtu Wu, Wei Shi, Peihai Zhang, Huifang Zhang, Guoqin Wang, Jin Wang, Guihuai Wang
Abstract
ObjectiveTo explore the advantages of O-arm-navigated pedicle screw insertion in patients with spinal column and spinal cord tumors.
MethodsWe retrospectively enrolled 29 patients with spinal tumors who underwent pedicle placement using O-arm-based navigation (Group A, 21 cases) or freehand technique (Group B, 8 cases) at Department of Neurosurgery, Beijing Tsinghua Changgung Hospital, Tsinghua University from October 2015 to December 2017. Screw position was judged on the 3D O-arm images and the accuracy of screws placement was evaluated according to the Gertzbein-Robbins scale. The clinical data and neuroimaging data were collected during the follow-up.
ResultsAge, sex, body mass index, mean blood loss, length of stay and radiation dose showed no significant difference (all P>0.05) between the 2 groups. The operation time in group A was longer than that in group B (109.7±59.9 min vs. 74.5±19.4 min, P=0.025). A total of 134 screws were inserted in Group A and 117 screws was classified as grade A, 11 as grade B and 6 as grade C. There were 45 screws inserted in group B and 34 screws were classified as grade A, 4 as grade B, 6 as grade C and 1 as grade D. The accuracy of screw inserting was significantly different between the 2 groups (group A: 95.5% and group B: 84.4%, χ2=4.604, P=0.032). No screw-related neurovascular complications occurred.
ConclusionO-arm-based navigation system could markedly improve the accuracy of screw insertion and thus help reconstruct spinal stability.
Key words:
Spinal cord neoplasms; Spinal neoplasms; Neuronavigation; O-arm; Spinal fixation
Contributor Information
Linkai Jing
Department of Neurosurgery, Beijing Tsinghua Changgung Hospital, Tsinghua University, Beijing 102218, China
School of Clinical Medicine, Tsinghua University, Beijing 100084, China
Zhenxing Sun
Department of Neurosurgery, Beijing Tsinghua Changgung Hospital, Tsinghua University, Beijing 102218, China
School of Clinical Medicine, Tsinghua University, Beijing 100084, China
Yi Guo
Department of Neurosurgery, Beijing Tsinghua Changgung Hospital, Tsinghua University, Beijing 102218, China
School of Clinical Medicine, Tsinghua University, Beijing 100084, China
Youtu Wu
Department of Neurosurgery, Beijing Tsinghua Changgung Hospital, Tsinghua University, Beijing 102218, China
School of Clinical Medicine, Tsinghua University, Beijing 100084, China
Wei Shi
Department of Neurosurgery, Beijing Tsinghua Changgung Hospital, Tsinghua University, Beijing 102218, China
School of Clinical Medicine, Tsinghua University, Beijing 100084, China
Peihai Zhang
Department of Neurosurgery, Beijing Tsinghua Changgung Hospital, Tsinghua University, Beijing 102218, China
School of Clinical Medicine, Tsinghua University, Beijing 100084, China
Huifang Zhang
Department of Neurosurgery, Beijing Tsinghua Changgung Hospital, Tsinghua University, Beijing 102218, China
School of Clinical Medicine, Tsinghua University, Beijing 100084, China
Guoqin Wang
Department of Neurosurgery, Beijing Tsinghua Changgung Hospital, Tsinghua University, Beijing 102218, China
School of Clinical Medicine, Tsinghua University, Beijing 100084, China
Jin Wang
Department of Neurosurgery, Beijing Tsinghua Changgung Hospital, Tsinghua University, Beijing 102218, China
School of Clinical Medicine, Tsinghua University, Beijing 100084, China
Guihuai Wang
Department of Neurosurgery, Beijing Tsinghua Changgung Hospital, Tsinghua University, Beijing 102218, China
School of Clinical Medicine, Tsinghua University, Beijing 100084, China
