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Efficacy of Atlantoaxial Transarticular Screw Fixation Using Navigation-Guided Drill: Technical Note
Takeshi Hara1, Hirokazu Iwamuro1, Yukoh Ohara1
1Department of Neurosurgery, Juntendo University, Tokyo, Japan.
World Neurosurgery
|November 8, 2019
Summary
Atlantoaxial transarticular screw fixation (TASF) using 3D navigation reduces risks. This technique ensures accurate K-wire placement, preventing damage to vital structures and improving patient safety.
Area of Science:
- Neurosurgery
- Orthopedic Surgery
- Spinal Surgery
Background:
- Atlantoaxial transarticular screw fixation (TASF) carries risks of injury to adjacent structures like the vertebral artery.
- Misinsertion of K-wires or screws can lead to complications during TASF.
Purpose of the Study:
- To evaluate the safety and efficacy of 3D navigation-guided drilling for TASF.
- To assess the risk reduction associated with navigation-guided TASF.
Main Methods:
- Three patients underwent TASF using intraoperative CT-guided navigation.
- The navigation system guided screw insertion tract creation to avoid critical structures.
- A blunt-tipped guide wire was employed for safe advancement.
Main Results:
- No complications or instrument failures were reported in any of the three cases.
- Successful bone fusion was achieved in all patients.
- Radiation exposure was within acceptable limits (5.31-7.02 mGy, 55.6-106.8 seconds).
Conclusions:
- Navigation-guided TASF facilitates accurate K-wire and screw placement.
- This technique effectively prevents damage to vital adjacent structures.
- 3D navigation significantly lowers the procedural risks associated with TASF.
