Department of Orthopaedic Surgery, Okayama Rosai Hospital, Okayama 702-8055, Japan.
Department of Scoliosis and Spine Department, KAT Hospital, 14-561 Athens, Greece.
Medicina (Kaunas). 2023 Oct 6;59(10):1779. doi: 10.3390/medicina59101779.
: C-arm-free MIS techniques can offer significantly reduced rates of postoperative complications such as inadequate decompression, blood loss, and instrumentation misplacement. Another advantageous long-term aspect is the notably diminished exposure to radiation, which is known to cause malignant changes. This study emphasizes that, in some cases of spinal conditions that require a procedural intervention, C-arm-free MIS techniques hold stronger indications than open surgeries guided by image intensifiers. : This study includes a retrospective analysis and review of various cervical and thoracic spinal procedures, performed in our hospital, applying C-arm-free techniques. The course of this study explains the basic steps of the procedures and demonstrates postoperative and intraoperative results. For anterior cervical surgery, we performed OPLL resection, while for posterior cervical surgery, we performed posterior fossa decompression for Chiari malformation, minimally invasive cervical pedicle screw fixation (MICEPS), and modified Goel technique with C1 lateral mass screw for atlantoaxial subluxation. Regarding the thoracic spine, we performed anterior correction for Lenke type 5 scoliosis and transdiscal screw fixation for diffuse idiopathic skeletal hyperostosis fractures. : C-arm-free techniques are safe procedures that provide precise and high-quality postoperative results by offering sufficient spine alignment and adequate decompression depending on the case. Navigation can offer significant assistance in the absence of normal anatomical landmarks, yet the surgeon should always appraise the quality of the information received from the software. : Navigated C-arm-free techniques are safe and precise procedures implemented in the treatment of surgically demanding conditions. They can significantly increase accuracy while decreasing operative time. They represent the advancement in the field of spine surgery and are hailed as the future of the same.
无 C 臂微创 MIS 技术可显著降低术后并发症的发生率，如减压不充分、失血和器械错位。另一个有利的长期方面是显著减少辐射暴露，已知辐射会导致恶性变化。本研究强调，在某些需要手术干预的脊柱疾病情况下，无 C 臂微创 MIS 技术比在图像增强器引导下进行的开放手术具有更强的适应证。
本研究回顾性分析了我院应用无 C 臂技术进行的各种颈椎和胸椎脊柱手术。本研究介绍了手术的基本步骤，并展示了术后和术中结果。对于前路颈椎手术，我们进行了 OPLL 切除，对于后路颈椎手术，我们进行了 Chiari 畸形的后颅窝减压、微创颈椎经皮螺钉固定术（MICEPS）、改良 Goel 技术和 C1 侧块螺钉固定寰枢关节半脱位。对于胸椎，我们进行了 Lenke 型 5 脊柱侧凸的前路矫正和弥漫性特发性骨肥厚骨折的经椎间盘螺钉固定。
无 C 臂技术是一种安全的手术方法，根据具体情况提供精确的脊柱对线和充分的减压，从而获得高质量的术后效果。在正常解剖标志缺失的情况下，导航可以提供显著的帮助，但外科医生应始终评估从软件接收到的信息的质量。
导航无 C 臂技术是一种安全、精确的手术方法，适用于治疗具有挑战性的疾病。它可以显著提高准确性，同时缩短手术时间。它代表了脊柱外科领域的进步，被誉为该领域的未来。
