Comparison between O-arm Navigation and Conventional Fluoroscopic Guidance in Corrective Posterior Fixation for Cervical Spinal Injury

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  • Takamatsu Nobutoshi
    Department of Orthopedic Surgery, Tokushima Prefecture Naruto Hospital, Naruto, Tokushima, Japan Department of Orthopedic Surgery, Tokushima Prefectural Central Hospital, Kuramoto, Tokushima, Japan
  • Manabe Hiroaki
    Department of Orthopedic Surgery, Tokushima Prefecture Naruto Hospital, Naruto, Tokushima, Japan Department of Orthopedics, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, Japan
  • Yokoo Yuki
    Department of Orthopedic Surgery, Tokushima Prefecture Naruto Hospital, Naruto, Tokushima, Japan
  • Wada Kazuma
    Department of Orthopedic Surgery, Tokushima Prefecture Naruto Hospital, Naruto, Tokushima, Japan
  • Hirano Tetsuya
    Department of Orthopedic Surgery, Tokushima Prefecture Naruto Hospital, Naruto, Tokushima, Japan
  • Hibino Naohito
    Department of Orthopedic Surgery, Tokushima Prefecture Naruto Hospital, Naruto, Tokushima, Japan
  • Henmi Tatsuhiko
    Department of Orthopedic Surgery, Tokushima Prefecture Naruto Hospital, Naruto, Tokushima, Japan
  • Chikawa Takashi
    Department of Orthopedic Surgery, Tokushima Prefecture Naruto Hospital, Naruto, Tokushima, Japan
  • Sairyo Koichi
    Department of Orthopedics, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, Japan

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<p>Purpose : To compare the effectiveness of O-arm navigation with that of conventional fluoroscopic guidance in corrective posterior fixation for cervical spinal injury. Methods : This retrospective comparative study involved 11 consecutive patients who underwent corrective posterior fixation using O-arm navigation or conventional fluoroscopy for cervical spinal injury between February 2016 and May 2021. Patient-specific characteristics (age and sex), number of screws, number of pedicle screws, accuracy of pedicle screw insertion, number of vertebral bodies fixed, operating time, and length of hospital stay were analyzed using the t-test. A P-value  < 0.05 was considered statistically significant. Results : Corrective posterior fixation was performed under O-arm navigation in 5 patients and under conventional fluoroscopic guidance in 6. A significantly greater number of pedicle screws was used in the O-arm group (6.4 vs 2.7, P = 0.046). According to the Neo classification for pedicle screw placement, there were no grade 2 or 3 breaches. No other items showed a significant difference between the groups (P > 0.05). Conclusion : O-arm navigation can improve the accuracy of cervical pedicle screw insertion. Its introduction could expand the indications for use of pedicle screws in posterior fixation of cervical spinal injury beyond those that are possible using conventional fluoroscopy. J. Med. Invest. 69 : 273-277, August, 2022</p>

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