Akgun Mehmet Yigit, Manici Mete, Ates Ozkan, Gokdemir Melis, Gunerbuyuk Caner, Tepebasili Mehmet Ali, Baran Oguz, Akgul Turgut, Oktenoglu Tunc, Sasani Mehdi, Ozer Ali Fahir
Department of Neurosurgery, Koc University Hospital, 34010 Istanbul, Turkey.
Spine Center, Koc University Hospital, 34010 Istanbul, Turkey.
Diagnostics (Basel). 2024 Aug 7;14(16):1712. doi: 10.3390/diagnostics14161712.
In spine surgery, ensuring the safety of vital structures is crucial, and various instruments contribute to the surgeon's confidence. This study aims to present outcomes from spinal cases operated on using the freehand technique and neuronavigation with an O-arm in our clinic. Additionally, we investigate the impact of surgical experience on outcomes by comparing early and late cases operated on with neuronavigation.
We conducted a retrospective analysis of spinal patients operated on with the freehand technique and neuronavigation in our clinic between 2019 and 2020, with a minimum follow-up of 2 years. Cases operated on with neuronavigation using the O-arm were categorized into early and late groups.
This study included 193 patients, with 110 undergoing the freehand technique and 83 operated on utilizing O-arm navigation. The first 40 cases with neuronavigation formed the early group, and the subsequent 43 cases comprised the late group. The mean clinical follow-up was 29.7 months. In the O-arm/navigation group, 796 (99%) of 805 pedicle screws were in an acceptable position, while the freehand group had 999 (89.5%) of 1117 pedicle screws without damage. This rate was 98% in the early neuronavigation group and 99.5% in the late neuronavigation group.
The use of O-arm/navigation facilitates overcoming anatomical difficulties, leading to significant reductions in screw malposition and complication rates. Furthermore, increased experience correlates with decreased surgical failure rates.
在脊柱手术中，确保重要结构的安全至关重要，各种器械有助于增强外科医生的信心。本研究旨在展示在我们诊所使用徒手技术和O型臂神经导航进行脊柱手术的病例结果。此外，我们通过比较早期和晚期使用神经导航进行手术的病例，研究手术经验对结果的影响。
我们对2019年至2020年期间在我们诊所使用徒手技术和神经导航进行手术的脊柱患者进行了回顾性分析，最短随访时间为2年。使用O型臂进行神经导航手术的病例分为早期和晚期两组。
本研究包括193例患者，其中110例采用徒手技术，83例采用O型臂导航手术。前40例神经导航病例为早期组，随后的43例为晚期组。平均临床随访时间为29.7个月。在O型臂/导航组中，805枚椎弓根螺钉中有796枚（99%）位置可接受，而徒手组1117枚椎弓根螺钉中有999枚（89.5%）无损伤。早期神经导航组的这一比例为98%，晚期神经导航组为99.5%。
使用O型臂/导航有助于克服解剖困难，显著降低螺钉位置不当和并发症发生率。此外，经验增加与手术失败率降低相关。
