Placement Of Cervical Pedicle Screw Based On X-ray 3D Navigation System

ObjectiveAs a new technique,X-ray three dimensional navigation system has not been applied in orthopedics widely. This study try to explore the clinical application and curative effect of this new technique for cervical fracture and dislocation by studying the cervical pedicle screw fixation based on X-ray three dimensional navigation system.MethodsFrom October 2006 to November 2008, 31 patients accepted cervical pedicle screw placement based on X-ray 3D navigation system. Among them 9 patients accepted atlantoaxial fusion,4 accepted cervifix fixation and 18 accepted lower cervical spine operations. 154 screws were planted. These 31 patients included 22 male and 9 female with a mean age of 39 years (range from 17 to 49 years).The pedicle screw position was assessed with "C" arm fluoroscopy during operation. After operation C-Spine PA & LAT and CT was performed. The pedicle screw position was assessed on Andrew Scoring System. We collect 11 cases since 2004 performed cervical pedicle screw fixation based on X-ray fluoroscopy. The accuracy of both groups was compared using statistical method.ResultsNavigation group: 154 screws were planted."C" arm fluoroscopy showed reduction of fracture was satisfactory. After operation C-Spine PA & LAT and CT were made in all cases. CT examintion showed that 148 screws were in class I (96.1%)and 6 screws were in class II(3.9%) according to the criteria of Andrew radiographicgrade. No obvious complication was observed.Contrast group:46 screws were planted.39 screws were in class I (84.8%)and 7 screws were in class II (15.2%). No obvious complication was observed.The difference was statistically significant(P<0.05).ConclusionCompared with traditional operation methods, the cervical pedicle screw fixation based on X-ray three dimensional navigation system is more direct,more accurate and more secure.SignificanceThe cervical pedicle screw fixation has always been a difficult point in cervical internal fixation because of its risks. With the X-ray three dimensional navigation system's involvement this problem is solved perfectly. Performed by an experienced specialist who is familiar to the theory and manipulation of navigation system,this method make cervical pedicle screw fixation more secure and more accurate. Patients will benefit much from it. So this technique has bright application and population prospects in cervical internal fixation.