Thoracic Pedicle Screw Placement Guided by 3D-CT / 中国微创外科杂志

ABSTRACT

Objective To evaluate the accuracy of 3D-CT navigation in guiding pedicle screw fixation in the thoracic spine.Methods Thoracic pedicle screw placement guided by 3D-CT navigation was performed on 24 cases,including 14 patients with thoracic spine fractures,6 thoracic tumors,and 4 scoliosis.CT data was input into the navigation system,and point-matching test was chosen.The optimal position,diameter,and length of the screw were set up using navigation stick after true-up.Then,the screw was placed dynamically in a stereo way according to navigation plan.After the operation,the position of the pedicle screw was assessed with CT using the Rampersaud grading system.Results Under the guidance of 3D-CT navigation,a total of 144 screws were successfully fixed into the 24 patients.According to the Rampersaud grading system,136 of the screws were at grade A(94.4%),6 at grade B,1 grade C,and 1 grade D.No postoperative injury of the nerve or spinal cord was observed.Of the patients,22 were followed up for a mean of 8 months(range,6-14 months).During the follow-up,no loose or breakage of the screw was detected by X-ray and CT.No delayed spinal cord injury was found.Conclusions The thoracic pedicle screw placement can be accurately guided by 3D-CT navigation.