Optimization of Paravertebral Foramen Screw Placement: A Stepwise Approach Considering O-arm Navigation Errors:...

Area of Science:

• Neurosurgery
• Orthopedic Surgery
• Spinal Instrumentation

Background:

• Paravertebral foramen screws (PVFSs) offer improved pullout strength and reduced risk of neurovascular injury compared to pedicle screws.
• Conventional lateral fluoroscopy for PVFS insertion has limitations in reliability.
• Navigation-assisted techniques are emerging for spinal instrumentation but require precise methods.

Purpose of the Study:

• To evaluate the accuracy of a novel stepwise paravertebral foramen screw (PVFS) insertion technique using O-arm navigation.
• To compare the accuracy of navigation-guided stepwise PVFS insertion with conventional methods.

Main Methods:

• Retrospective analysis of 12 patients (78 PVFSs) undergoing cervical spine fixation with stepwise PVFS under O-arm navigation.
• Evaluation of screw placement accuracy via postoperative computed tomography (CT) scans.

Main Results:

• 90% (70/78) of PVFSs were placed in the ideal position.
• No adverse events related to screw insertion were reported.
• No screw loosening was observed at the final follow-up.

Conclusions:

• The stepwise PVFS method under navigation guidance achieves high accuracy in screw placement.
• This technique offers a potentially more reliable alternative to conventional fluoroscopy-guided PVFS insertion.
• The method shows promise for enhancing safety and efficacy in cervical spine fixation.