Application Of O-arm Navigation For Anterior Cervical Pedicle Screw Fixation

Background: With the development of social economy,the incidence of cervical vertebrae fractures,cervical vertebrae tumors,cervical vertebrae tuberculosis and cervical vertebrae degeneration caused by various physical,chemical and biological factors is increasing year by year.Those who are seriously ill even lose their ability to work and give patients The inconvenience caused by life and work also imposes an economic burden on society and families.Based on the characteristics of the above diseases,clinical studies have shown that early surgery is conducive to early rehabilitation,and different surgical procedures have their own advantages and disadvantages.The surgical methods were mainly selected according to their indications,including anterior and posterior cervical approach and anterior cervical pedicle screw fixation.Both procedures can provide stable biomechanical stability,but the former has a long treatment period.Shortcomings such as large trauma and long time;the latter is limited by the development of equipment and the technical requirements of the opposing nails,which limits its clinical application.In view of the above factors,this study used O-arm navigation equipment to assist the cervical anterior pedicle screw placement in the treatment of cervical spondylosis,evaluate its clinical effect,and compare the effect of combined anterior and posterior approaches.Objective: To evaluate the curative effect of anterior cervical pedicle screw fixation for cervical spondylosis and compare it with the treatment of cervical anterior and posterior approach.Methods: A retrospective analysis of cervical spine decompression and bone grafting and internal fixation for the treatment of cervical spine trauma or degeneration with osteoporosis,cervical vertebral tumor and cervical vertebral body from April 2015 to April 2018 There were 46 cases of tuberculosis,including 26 males and 20 females,aged between 30 and 75 years,with an average age of 59.8±5.5 years.30 cases of anterior and posterior cervical decompression and bone graft fusion with vertebral screw fixation were performed.Group A),16 patients with anterior cervical decompression and pedicle screw fixation(group B),followed up for 6 to 32 months.The operation time,the amount of bleeding;the cervical curvature;the Japanese orthopedics JOA score to evaluate the recovery of postoperative neurological function;the imaging results to evaluate the bone graft fusion rate;the O-arm navigation nail placement great rate;the postoperative complications statistical results.Results: The intraoperative blood loss,operation time and hospitalization time in group A were(100.6±21.1)ml,(2.12±0.54)h,(14.5±3.5)d,respectively.The amount of intraoperative blood loss,operation time and hospitalization time in group B were respectively(36.2 ± 13.4)ml,(1.25 ± 0.37)h,(10.3 ± 2.3)d.Compared with group B,group A had less bleeding and shorter operation time,and the difference was statistically significant(P<0.05).Cervical curvature: Group A,preoperative,1 week,6 months,and last follow-up scores were 16.7±2.5°,15.4±1.7°,13.3±1.6°,12.4±2.1°,respectively;The scores of 1 week,postoperative 6 months,and last follow-up were 17.1±2.7°,17.1±2.7°,15.9±2.1°,and 15.9±2.1°,respectively.There was no significant difference between the two groups after 1 week.p>0.05);6 months after operation,the last follow-up,the difference was statistically significant(P<0.05).JOA score: There was no significant difference in the spinal cord function between the two groups(P>0.05).Fusion rate of vertebral body grafting: The bone graft fusion rate was 76.7% in group A and 60.0% in the last follow-up.The bone graft fusion rate was 75.0% in group B after 6 months.The bone graft fusion rate at the last follow-up.93.7%;O-arm navigation nailing excellent rate: 57 grade nails,1 grade 1 nail,1 grade 2 nails,no grade 3 and above nails.Postoperative complications: 1 case of dysphagia and 4 cases of axial symptoms in group A.One patient in group B developed dysphagia.Conclusion: 1.Anterior cervical pedicle screw fixation is effective for cervical trauma or degeneration with osteoporosis,cervical tumor,cervical tuberculosis,etc.It has the advantages of shorter operation time,less bleeding and less trauma..2.O-arm navigation assisted cervical anterior pedicle screw placement is safe and accurate,which can effectively reduce the occurrence of complications and is worthy of clinical promotion and application.