COMPARING THE TRAJECTORY ACCURACY OF PEDICLE SCREWS PLACED WITH A FREE-HAND TECHNIQUE AND A THREE-DIMENSIONAL COMPUTED TOMOGRAPHY-ASSISTED NAVIGATION SYSTEM IN SPINE SURGERY: A RETROSPECTIVE STUDY


Cetiner E., AKESEN S., Billgin Y., Onder C., Guler S. B., AKESEN B.

JOURNAL OF ISTANBUL FACULTY OF MEDICINE-ISTANBUL TIP FAKULTESI DERGISI, cilt.86, ss.138-144, 2023 (ESCI) identifier identifier

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 86
  • Basım Tarihi: 2023
  • Doi Numarası: 10.26650/iuitfd.1198451
  • Dergi Adı: JOURNAL OF ISTANBUL FACULTY OF MEDICINE-ISTANBUL TIP FAKULTESI DERGISI
  • Derginin Tarandığı İndeksler: Emerging Sources Citation Index (ESCI), Scopus, TR DİZİN (ULAKBİM)
  • Sayfa Sayıları: ss.138-144
  • Anahtar Kelimeler: Spine deformity, navigation, posterior instrumenta-tion, INTERNAL-FIXATION, SCOLIOSIS
  • Bursa Uludağ Üniversitesi Adresli: Evet

Özet

Objective: We evaluated a free-hand technique and a three-di-mensional computerized tomography (3D-CT)-assisted naviga-tion technique, which are pedicle screw placement techniques used in spinal surgery, regarding screw placement and reliability.Material and Method: A total of 1664 screws in 73 patients with spinal deformities who underwent spinal instrumentation using pedicle screws were evaluated in this study. Forty patients were in the free-hand technique group, and 33 patients were in the 3D-CT-assisted navigation technique group. The placement and reliability of pedicle screws in all patients were evaluated using the Gertzbein-Robbins classification using CT images taken in the postoperative period.Result: There were no significant differences found regarding age, body mass index (BMI), sex (female or male), or deformity (scoliosis or kyphosis) (p>0.05). When the pedicle screws were evaluated in terms of transverse penetration, the 3D-CT-assisted navigation technique was determined Grade A (89.6%), as was the free-hand technique (76.5%), but the 3D-CT-assisted navi-gation technique was statistically more reliable (p<0.001). When the pedicle screws were evaluated in terms of anterior penetra-tion, both the 3D-CT-assisted navigation technique (92.5%) and the free-hand technique (82.9%) were determined Grade A, but the 3D-CT-assisted navigation technique was statistically more reliable (p<0.001).Conclusion: According to our studys results, the 3D-CT-assist-ed navigation technique is more reliable than the free-hand technique in surgeries involving spine deformities for pedicle screw insertion.