ArticleArchives of orthopaedic and trauma surgery2023
Accuracy of pedicle screw placement using neuronavigation based on intraoperative 3D rotational fluoroscopy in the thoracic and lumbar spine.
Article in Archives of orthopaedic and trauma surgery, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
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Who cites it
8 citing papers in PubMed, 10 citations in OpenAlex.
- The global landscape of robot-assisted pedicle screws: a bibliometric and thematic evolution analysis.Journal of robotic surgery · 2026Review
- Intraoperative O-arm navigation yields 100% accuracy in pedicle screw placement for adolescent idiopathic scoliosis: a single-institution study.Journal of spine surgery (Hong Kong) · 2025Article
- Lumbar spine deformation between prone and supine CTs.Neurosurgical review · 2025Article
- Intraoperative imaging adequacy and its impact on unplanned return-to-theatre rates in pedicle screw instrumentation.World journal of orthopedics · 2025Article
- Enhancing the Accuracy of Pedicle Screw Placement Using 3D-Printed Screw-Guiding Techniques in the Lumbosacral Region for Small Breed Dogs: A Cadaveric Study.Animals : an open access journal from MDPI · 2024Article
- Review
- Assessment of Navigated Pedicle Screws From Intraoperative Imaging: A Prospective Study of Accuracy and Agreement.International journal of spine surgery · 2023Article
- Article
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Authors and funding
8 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionIn spinal surgery, precise instrumentation is essential. This study aims to evaluate the accuracy of navigated, O-arm-controlled screw positioning in thoracic and lumbar spine instabilities. MATERIALS AND
methodsPosterior instrumentation procedures between 2010 and 2015 were retrospectively analyzed. Pedicle screws were placed using 3D rotational fluoroscopy and neuronavigation. Accuracy of screw placement was assessed using a 6-grade scoring system. In addition, screw length was analyzed in relation to the vertebral body diameter. Intra- and postoperative revision rates were recorded.
resultsThoracic and lumbar spine surgery was performed in 285 patients. Of 1704 pedicle screws, 1621 (95.1%) showed excellent positioning in 3D rotational fluoroscopy imaging. The lateral rim of either pedicle or vertebral body was protruded in 25 (1.5%) and 28 screws (1.6%), while the midline of the vertebral body was crossed in 8 screws (0.5%). Furthermore, 11 screws each (0.6%) fulfilled the criteria of full lateral and medial displacement. The median relative screw length was 92.6%. Intraoperative revision resulted in excellent positioning in 58 of 71 screws. Follow-up surgery due to missed primary malposition had to be performed for two screws in the same patient. Postsurgical symptom relief was reported in 82.1% of patients, whereas neurological deterioration occurred in 8.9% of cases with neurological follow-up.
conclusionsCombination of neuronavigation and 3D rotational fluoroscopy control ensures excellent accuracy in pedicle screw positioning. As misplaced screws can be detected reliably and revised intraoperatively, repeated surgery for screw malposition is rarely required.
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