ArticleJournal of craniovertebral junction & spine
Comparison of freehand versus navigation-assisted C2 pedicle screw fixation: A retrospective accuracy and safety analysis.
Article in Journal of craniovertebral junction & spine. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Authors and funding
6 authors.
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Abstract
Background: C2 transpedicular screw fixation is a biomechanically robust technique for upper cervical stabilization yet remains technically demanding due to anatomical complexity. Study Design: This was a retrospective nonrandomized comparative study. Objective: Using validated radiological classification systems, this study aims to compare the accuracy, malposition rates, and complication profiles of C2 screw placement using both freehand and navigation-assisted approaches. Materials and Methods: Between 2010 and 2019, 100 patients who underwent C2 pedicle screw fixation at two different institutions were included in a retrospective study. There were 197 screws in all: 45 using a freehand technique (FH group) and 152 using a navigation-assisted approach (NA group). Using both Gertzbein-Robbins classification (GRC) and screw zone classification (SZC), screw accuracy was evaluated. Between the groups, demographic, clinical, and surgical data were statistically compared. Results: The mean age was significantly higher in the NA group (75.37 ± 16.15) than in the FH group (46.29 ± 22.14) ( Conclusions: In C2 pedicle screw placement, both freehand and navigation-assisted techniques showed great accuracy and low complication rates. Although navigation systems provide improved accuracy in the hands of experienced users, the freehand technique remains a safe and efficient alternative. Surgeon experience, patient anatomy, and institutional resources should all help guide the choice of technique.
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