A new study published in The Journal of Spinal Disorders and Techniques examines navigation and O-arm-guided pedicle screw placement with navigation compared to pedicle screw placement with fluoroscopy.
There were 138 pedicle screws placed with fluoroscopy and 124 placed with navigation for the study. The researchers found:
1. In the fluoroscopy-guided group, 87.7 percent of the screws were a "grade 0." In the navigation group, 91.9 percent of the screws were "grade 0."
2. In 35.3 percent of the fluoroscopy-guided cases, the lateral cortex was most commonly involved. The medial cortex was most common in the navigation-guided group, where it was involved in 40 percent of the cases.
3. The average screw placement preparation time was 3.7 minutes for the fluoroscopy-guided group and 14.2 minutes for the navigation-guided group.
4. The average screwing time was 3.6 minutes in the fluoroscopy-guided group and 4.3 minutes for the navigation-guided group.
5. In the fluoroscopy-guided group, there were 6.5 shots for each screw placement.
6. There were two patients who had misplaced screws under fluoroscopy guidance that presented ipsilateral leg paresthesia that could have been related to screw position.
"The present prospective study reveals that the pedicle screw placement guided by the navigation coupled with O-arm system was more accurate and safer than under fluoroscopy guidance," concluded the study authors.