O-arm intraoperative navigation was found to be safe and accurate in a 15-year study of cases involving thoracolumbar and sacral pedicle screw insertion, according to a study in the April 1 issue of Spine.
The study looked at patients who underwent thoracolumbar and sacral pedicle screw insertion using intraoperative imaging and navigation between 2009 and 2023. Researchers analyzed CT images for signs of pedicle wall breach, which was graded according to the Gertzbein classification. Breach rates were also computed.
A total 5,478 pedicle screws implanted with intraoperative navigation guidance were analyzed. There was a 98.63% insertion accuracy rate, and the rate of major breaches was 0.55%. Overall breach rate was 1.64%, and there was no incidence of needing revision surgery.
The study concluded, “Our analysis of 5478 pedicle screws shows that O-arm navigation is safe and accurate, with a major breach rate of 0.55%. No patient in this cohort had any neurovascular injury, and the few screws with major breaches were fixed during the index procedure. There were no incidences of return to the operating theater for malpositioned screws in our 15-year study.”
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