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65th Annual Meeting of the German Society of Neurosurgery (DGNC)

German Society of Neurosurgery (DGNC)

11 - 14 May 2014, Dresden

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Accuracy of image guided pedicle screw placement in cervical, thoracic, lumbar and sacral levels using the O-arm 3D imaging system

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  • Mohamed Boshara - Klinik für Neurochirurgie, Köln-Merheim Medical Center, Universität Witten-Herdecke, Deutschland
  • Mehran Mahvash - Klinik für Neurochirurgie, Köln-Merheim Medical Center, Universität Witten-Herdecke, Deutschland
  • Holger Schlag - Klinik für Neurochirurgie, Köln-Merheim Medical Center, Universität Witten-Herdecke, Deutschland
  • Alhadi Igressa - Klinik für Neurochirurgie, Köln-Merheim Medical Center, Universität Witten-Herdecke, Deutschland
  • Ioannis Pechlivanis - Klinik für Neurochirurgie, Köln-Merheim Medical Center, Universität Witten-Herdecke, Deutschland
  • Friedrich Weber - Klinik für Neurochirurgie, Köln-Merheim Medical Center, Universität Witten-Herdecke, Deutschland

Deutsche Gesellschaft für Neurochirurgie. 65. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC). Dresden, 11.-14.05.2014. Düsseldorf: German Medical Science GMS Publishing House; 2014. DocMO.11.04

doi: 10.3205/14dgnc064, urn:nbn:de:0183-14dgnc0642

Published: May 13, 2014

© 2014 Boshara et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.

Outline

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Objective: Image guided techniques in spinal surgery are used increasingly for pedicle screw placement. The O-arm imaging and navigation system provides intraoperative 3-dimensional images for spinal navigation. The aim of this study was to evaluate the accuracy of pedicle screw placement in cervical, thoracic, lumbar and sacral levels in a large number of patients using the O-arm imaging and Stealth navigation system.

Method: Patients planned for spinal stabilization with pedicle screw implantation were operated using the O-arm as imaging device and the Stealth station as navigation tool (Medtronic). The accuracy of the pedicle screw placement was evaluated and classified into five groups: screws placed exactly within the pedicle were evaluated as group A, screws deviating <2 mm as group B, > or = 2 mm to <4 mm as group C; > or = 4 mm to 6 mm as group D and more than 6 mm as group E.

Results: A total of 1736 cervical (n=16, 0.9%), thoracic (n=618, 35.5%), lumbar (n=996, 57.4%) and sacral (n=106, 6.1%) pedicle screws were evaluated in 412 patients (mean age 62 year, range 18-86 years, female to male ratio 1:1). In axial plane, 97.3% of the screws were classified as group A and 1.7% as group B. In longitudinal plane, 98.2% of the screws were evaluated as group A and 1.1% as group B. Only 4 (0.23%) screws needed to be revised.

Conclusions: Image guided pedicle screw placement using the O-arm intraoperative image system is a safe and reliable technique with very high accuracy.