Clinical application of neuronavigation system in the spinal fixation surgery

Yu Qi; Zhao Hongyu; Liu Yunhui

doi:10.11850/j.issn.1009-122X.2014.07.006

Abstract：Objective To explore the superiority and short-term effect of the pedicle screws placement assisted by neuronavigation system in the spinal surgery. Methods Seventy-six pedicle screws were inserted into 17 patients under assistance by neuronavigation system. The single vertebral registration time, screw channel preparation time, intraoperative blood loss, times of C-arm irradiation, accuracy of the neuronavigation, times of pedicle screw replacement and the complications were recorded. The locations of pedicle screws were evaluated by postoperative CT scan. Results The average single vertebral registration time was 6.3±2.1 min, average screw channel preparation time was 2.6±1.3 min, average intraoperative blood loss was 253±70 ml, average uses of C-arm was 3.5±0.5 times, and average accuracy of the neuronavigation was 0.9±0.1 mm. The assessment of pedicle screws location was carried out according to Richter method. In all the pedicle screws inserted, the result was excellent in 70 screws, good in 5 and bad in 1 screw, and the effectiveness rate was 98.68%. There were 4 pedicle screws reimplanted in the operation and the reimplantation rate was 5.26%. Ten patients were followed up for 3 to 7 months, and there were no positive neurological signs. Conclusions With the help of neuronavigation, the procedures of the insertion can be real-time monitored, and the size, location of the pedicle screws evaluated prospectively, which will improve the accuracy and security.