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A new 3-dimensional method for measuring precision in surgical navigation and methods to optimize navigation

Christopher J Kleck1, Ian Cullilmore2, Matthew LaFleur3

  • 1Department of Orthopedics, University of Colorado Anschutz Medical Campus, 12631 E. 17th Ave, Mail Stop B202, Aurora, CO, 80045, USA. christopher.kleck@ucdenver.edu.

European Spine Journal : Official Publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society
|September 24, 2015
PubMed
Summary

This study introduces a new 3D method using O-arm and StealthStation navigation for precise pedicle screw placement in spinal surgery. The technique achieved 97% accuracy, demonstrating a safe and effective approach for improving surgical outcomes.

Keywords:
Free-handNavigationO-armPedicle screw

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Area of Science:

  • Spinal Surgery
  • Medical Imaging
  • Surgical Navigation

Background:

  • Pedicle screw placement is critical in spinal surgery.
  • Accurate screw placement ensures spinal stability and prevents neurological complications.
  • Existing methods may have limitations in precision and 3D evaluation.

Purpose of the Study:

  • To describe and evaluate a novel 3D method for assessing pedicle screw placement accuracy.
  • To identify sources of error and provide guidance for precise screw insertion using O-arm and StealthStation navigation.
  • To determine the accuracy and safety of this navigation-assisted technique.

Main Methods:

  • Utilized O-arm and StealthStation navigation for pedicle screw placement.
  • Acquired initial and final O-arm scans for comparison.
  • Analyzed projected probe and screw tracks against final screw positions to assess precision and accuracy.

Main Results:

  • Achieved 97% accuracy with 153 out of 158 screws in adequate positions.
  • Only 5 screws required revision due to lateral breaches, with no neurological complications.
  • Demonstrated mean screw tip distances of 6.43 mm (navigated probe) and 5.92 mm (navigated probe and screwdriver).
  • Showed mean angle differences of 4.02° and 3.09°, respectively, indicating high precision.

Conclusions:

  • The novel 3D evaluation technique enhances the definition of pedicle screw placement.
  • StealthStation navigation proved accurate and safe for pedicle screw positioning.
  • Preliminary findings identified factors influencing screw placement precision, guiding future improvements.