[Intraoperative CT navigation in spinal and pelvic surgery: initial experience]

Area of Science:

• Spinal Surgery
• Orthopedic Surgery
• Medical Imaging

Background:

• Presents the initial clinical experience with perioperative CT navigation for pelvic and spine screw placement.
• Highlights the transition from standard C-arm fluoroscopy to an O-arm imaging system for navigation.

Purpose of the Study:

• To evaluate the feasibility and outcomes of CT-navigated screw insertion in complex spinal and pelvic procedures.
• To assess the impact of CT navigation on operative time, accuracy, and complications.

Main Methods:

• Conducted 15 CT-navigated pelvic and spine operations in 14 patients over a 3-month period.
• Utilized an O-arm imaging system for perioperative navigation and screw trajectory verification.
• Indications included nerve root compression, scoliosis, fractures, and spondylodiscitis.

Main Results:

• Successfully inserted 73 screws (60 spinal, 9 iliosacral, 4 pubic) with a 1.4% malposition rate for pubic screws.
• No major complications or conversions to standard fluoroscopy were required.
• Demonstrated high accuracy in screw placement across various spinal and pelvic regions.

Conclusions:

• CT navigation significantly reduces operating time and minimizes screw malposition in spinal procedures.
• CT navigation enhances the accuracy of iliosacral and pubic screw placement in pelvic surgery.
• This technique offers near-zero radiation exposure for staff and enables wider adoption of minimally invasive fixation.