Experimental study and clinical applications of computer assisted navigation technique in spinal surgery / 中华骨科杂志

ABSTRACT

Objective To assess the accuracies and feasibility of spine surgery assisted by different types of navigation system.Methods In experiment study,40 human cadaveric cervical spines were employed and 3.5 mm screws were placed into the C 3 to C 7 pedicles following five kinds of insertion techniquesblind screw placement(Group 1),assisted by X-ray fluoroscopy(Group 2),assisted by virtual fluoroscopy navigation system(Group 3),assisted by CT-based navigation system(Group 4),assisted by Iso-C 3D navigation system(Group 5).Thereafter,cortical integrity of every sample was examined by anatomic dissection.In clinical study,163 cases of spine operations assisted by different types of navigation were reviewed.The accuracies of screw placement were evaluated by postoperative CT or Iso-C 3D scan.Results In experiment study,there were 398 pedicles inserted.Group 1,the average operation time per sample was 27 minutes;36.3% of the screws were excellent,26.3% good,and 37.5% bad.Group 2,the average operation time was 112 minutes;44.9% excellent,37.2% good,and 17.9% bad.Group 3,the average operation time was 69 minutes;42.5% excellent,45.0% good,and 12.5% bad.Group 4,the average operation time was 98 minutes;87.5% excellent,12.5% good.Group 5,the average operation time was 91 minutes;90% excellent,10% good.In clinical study,272 screws inserted with virtual fluoroscopy navigation system,89.3% excellent,10.7% good.571 screws inserted with CT-based navigation system,84.9% excellent,14.4% good,0.7% bad.142 screws inserted with Iso-C 3D navigation system,95.8% excellent,4.2% good.Conclusion Computer-assisted navigation system enhances accuracies and further improves the safety of spine surgery,especially utilizing CT-based navigation system and Iso-C 3D navigation system.Iso-C 3D navigation method is better than the other two navigation methods.