A Novel Technique for Intraoperative Navigation in Occipitocervical Fusion: A Preliminary Report

Area of Science:

• Neurosurgery
• Pediatric Orthopedics
• Spine Surgery

Background:

• Intraoperative navigation enhances screw placement accuracy in pediatric occipitocervical fusion.
• Existing navigated techniques typically apply navigation from the start of the procedure for all instrumentation.
• A novel navigated technique for pediatric occipitocervical fusion is presented.

Purpose of the Study:

• To describe a novel technique for navigated occipitocervical fusion in pediatric patients.
• To analyze the short-term outcomes of this new technique.

Main Methods:

• A novel technique using intraoperative navigation was employed, with the reference array attached after occipital plate fixation.
• Navigation was specifically used for subaxial fixation, not occipital fixation.
• A retrospective review of pediatric cases treated with this technique was conducted.

Main Results:

• Three pediatric patients (median age 4 years) underwent fusion using the described technique.
• No intraoperative complications related to navigation or occipital fixation occurred.
• Complications such as dural leak, venous sinus penetration, or instrumentation dislodgement were avoided.

Conclusions:

• The described technique is effective for occipitocervical fusion in complex pediatric cases.
• The technique resulted in no intraoperative or postoperative navigation- or fixation-related complications.
• This approach may reduce operative time, navigation-related issues, and improve patient safety and construct alignment.