A novel screw view model of 3D navigation for upper cervical pedicle screw placement: A case report

RATIONALE: The purpose of this study is to introduce the technique of screw view model of navigation (SVMN) for upper cervical pedicle screw (UCPS) insertion. With the assistance of SVMN technology, the difficulty of screw placement manipulation can be diminished and the accuracy of placement can be improved. PATIENT CONCERNS: A 49-year-old man presented with numbness of extremities and limited activity for 2 years. DIAGNOSES: He was diagnosed with old fracture of C1 vertebra and atlantoaxial subluxation. INTERVENTIONS: We used SVMN to assist UCPS insertion and lateral mass screw insertion in this patient. OUTCOMES: A total of 2 pedicle screws and 2 lateral mass screws were inserted, all screws were defined as excellent position according to postoperative computer tomography (CT). The neurological function was intact postoperatively. The operation time was 293 minutes, the total fluoroscopic time was 4.1 minutes and the bleeding volume was 302 ml. There were no complications during the 48 months follow-up period. CONCLUSIONS: The application of SVMN in UCPS insertion could achieve satisfactory effect of internal fixation for upper cervical spine and avoid neurovascular damage. The utilization of SVMN for UCPS insertion is a safe and efficacious method. Besides, it also increased the patients’ hospital cost, and the surgeon must be quite familiar with the functional state of computer navigation.