[Clinical applications of computer-assisted navigation technique in spinal pedicle screw internal fixation].

OBJECTIVE

To assess the value of computer navigation technique in spinal pedicle screw insertion.

METHODS

95 patients undergoing spinal pedicle screw internal fixation were randomly divided in 2 groups:navigation group (n=36) undergoing pedicle screw insertion with computer-assisted navigation technique, and conventional group (n=50) undergoing pedicle screw insertion using conventional anatomic landmark combined. The 2 groups were compared in respect to screw canal preparation time, accuracy of screw position, and incidence of postoperative complication.

RESULTS

206 screws were inserted in the navigation group, 169 being with excellent outcome (82.0%), 29 with good outcome (14.1%), and 8 with bad outcome (3.9%). Nine patients in the navigation group failed to adopt the computer-assisted navigation technique because of different reasons. 285 screws were inserted in the conventional group, 257 being were excellent outcome (90.2%), 28 with good outcome (9.8%), and none with bad outcome. The general fitness rate of the navigation group was 96.1%, not significantly different from that of the conventional group (100%, P>0.05). The screw canal preparation time of the navigation group was (360+/-22) sec, significantly longer than that of the conventional group [(56+/-8) sec, P<0.001)]. No postoperative complication was found in both groups.

CONCLUSION

The accuracy of pedicle screw insertion using preoperative CT-based navigation technique is not different from that using conventional anatomic landmark, but the operation time is significantly prolonged. Preoperative CT-based navigation technique has limited value in spinal pedicle screw insertion.