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Usefulness of navigated O-arm(®) in a teaching center for spinal trauma

BACKGROUND: There is a relatively high incidence of screw misplacement during spinal instrumentation due to distortion of normal anatomy following spinal trauma. AIMS AND OBJECTIVES: To evaluate and share the initial experience with the use of neuro-navigated 3D O-arm(®) (Medtronic, USA) as compared...

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Autor principal: Agrawal, Deepak
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Medknow Publications & Media Pvt Ltd 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4849302/
https://www.ncbi.nlm.nih.gov/pubmed/27366260
http://dx.doi.org/10.4103/1793-5482.144179
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author Agrawal, Deepak
author_facet Agrawal, Deepak
author_sort Agrawal, Deepak
collection PubMed
description BACKGROUND: There is a relatively high incidence of screw misplacement during spinal instrumentation due to distortion of normal anatomy following spinal trauma. AIMS AND OBJECTIVES: To evaluate and share the initial experience with the use of neuro-navigated 3D O-arm(®) (Medtronic, USA) as compared to traditional 2D fluoroscopy in atrauma center in India. MATERIALS AND METHODS: In this retrospective study, consecutive patients of spinal injury who underwent screw fixation under O-arm guidance over nine-month period (July 2010 till March 2011) were evaluated for accuracy of screw placement. An equal number of consecutive patients prior to March 2011 who underwent screw fixation in 2D fluoroscopy were included for comparison. Patient demographics and radiology were reviewed and spinal injury was assessed using the ASIA grading in both the groups. Screw placement was assessed by postoperative CT scans of the relevant spine and accuracy of screw placement and breach of the medial or lateral cortex of the pedicle were recorded for each case. RESULTS: In the O-arm group, there were 57 patients in whom 210 screws were inserted. None of the patients had screw mal-placement. In 2D fluoroscopy group, 57 patients had 268 screws insertions. 10 (3.73%) screws were found to be malpositioned in the postoperative CT scans (8 in thoracic spine and 2 in odontoid fractures). The malposition rate was highly significant in 2D fluoroscopy thoracolumbar (P = 0.0015) subgroup. One patient had neurological deterioration and three patients required repositioning of the screws. CONCLUSION: In a teaching center with multiple surgeons, the O-arm(®) imaging ensures accurate placement of screws as compared to traditional 2D fluoroscopy.
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spelling pubmed-48493022016-07-01 Usefulness of navigated O-arm(®) in a teaching center for spinal trauma Agrawal, Deepak Asian J Neurosurg Original Article BACKGROUND: There is a relatively high incidence of screw misplacement during spinal instrumentation due to distortion of normal anatomy following spinal trauma. AIMS AND OBJECTIVES: To evaluate and share the initial experience with the use of neuro-navigated 3D O-arm(®) (Medtronic, USA) as compared to traditional 2D fluoroscopy in atrauma center in India. MATERIALS AND METHODS: In this retrospective study, consecutive patients of spinal injury who underwent screw fixation under O-arm guidance over nine-month period (July 2010 till March 2011) were evaluated for accuracy of screw placement. An equal number of consecutive patients prior to March 2011 who underwent screw fixation in 2D fluoroscopy were included for comparison. Patient demographics and radiology were reviewed and spinal injury was assessed using the ASIA grading in both the groups. Screw placement was assessed by postoperative CT scans of the relevant spine and accuracy of screw placement and breach of the medial or lateral cortex of the pedicle were recorded for each case. RESULTS: In the O-arm group, there were 57 patients in whom 210 screws were inserted. None of the patients had screw mal-placement. In 2D fluoroscopy group, 57 patients had 268 screws insertions. 10 (3.73%) screws were found to be malpositioned in the postoperative CT scans (8 in thoracic spine and 2 in odontoid fractures). The malposition rate was highly significant in 2D fluoroscopy thoracolumbar (P = 0.0015) subgroup. One patient had neurological deterioration and three patients required repositioning of the screws. CONCLUSION: In a teaching center with multiple surgeons, the O-arm(®) imaging ensures accurate placement of screws as compared to traditional 2D fluoroscopy. Medknow Publications & Media Pvt Ltd 2016 /pmc/articles/PMC4849302/ /pubmed/27366260 http://dx.doi.org/10.4103/1793-5482.144179 Text en Copyright: © 2016 Asian Journal of Neurosurgery http://creativecommons.org/licenses/by-nc-sa/3.0 This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 3.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms.
spellingShingle Original Article
Agrawal, Deepak
Usefulness of navigated O-arm(®) in a teaching center for spinal trauma
title Usefulness of navigated O-arm(®) in a teaching center for spinal trauma
title_full Usefulness of navigated O-arm(®) in a teaching center for spinal trauma
title_fullStr Usefulness of navigated O-arm(®) in a teaching center for spinal trauma
title_full_unstemmed Usefulness of navigated O-arm(®) in a teaching center for spinal trauma
title_short Usefulness of navigated O-arm(®) in a teaching center for spinal trauma
title_sort usefulness of navigated o-arm(®) in a teaching center for spinal trauma
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4849302/
https://www.ncbi.nlm.nih.gov/pubmed/27366260
http://dx.doi.org/10.4103/1793-5482.144179
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