STUDY DESIGN: A surgical simulation study in human cadaver spine specimens was conducted to evaluate the accuracy of 3 different surgical navigation systems compared to standard fluoroscopy in the percutaneous placement of iliosacral screws. OBJECTIVES: To compare the accuracy of percutaneous iliosacral screw placement using standard fluoroscopy, computer-assisted fluoroscopic image guidance, Iso-C3D image guidance (Medtronic Surgical Navigation Technologies, Louisville, CO), and electromagnetic fluoroscopic image guidance. SUMMARY OF BACKGROUND DATA: Conventional percutaneous sacroiliac screw placement has a malposition rate as high as 15%, as reported in the English-speaking literature (Hinsche et al [Clin Orthop Relat Res 2002;395:135-44] and Templeman et al [Clin Orthop Relat Res 1996;329:194-8]). Iso-C3D and computer-assisted image guidance technologies have been proposed to increase this accuracy rate. METHODS: Two iliosacral screws were placed bilaterally (4 screws) in each of 4 cadavers using standard fluoroscopy, computer-assisted fluoroscopic image guidance, Iso-C3D image guidance, and electromagnetic fluoroscopic image guidance. Screw positions were analyzed by computerized tomography after instrumentation and assigned a score based on deviation from ideal screw position. RESULTS: The StealthStation with FluoroNav (Medtronic Surgical Navigation Technologies) appeared to provide the highest accuracy of all guidance techniques. This result was more accurate than standard fluoroscopy. CONCLUSIONS: Computer-assisted fluoroscopy based image navigation appears to be more accurate than standard fluoroscopy in placing these screws. However, errors may occur with all techniques. Further refinement in registration procedures may highly improve the accuracy of percutaneous screw placement in a variety of spinopelvic procedures.
STUDY DESIGN: A surgical simulation study in human cadaver spine specimens was conducted to evaluate the accuracy of 3 different surgical navigation systems compared to standard fluoroscopy in the percutaneous placement of iliosacral screws. OBJECTIVES: To compare the accuracy of percutaneous iliosacral screw placement using standard fluoroscopy, computer-assisted fluoroscopic image guidance, Iso-C3D image guidance (Medtronic Surgical Navigation Technologies, Louisville, CO), and electromagnetic fluoroscopic image guidance. SUMMARY OF BACKGROUND DATA: Conventional percutaneous sacroiliac screw placement has a malposition rate as high as 15%, as reported in the English-speaking literature (Hinsche et al [Clin Orthop Relat Res 2002;395:135-44] and Templeman et al [Clin Orthop Relat Res 1996;329:194-8]). Iso-C3D and computer-assisted image guidance technologies have been proposed to increase this accuracy rate. METHODS: Two iliosacral screws were placed bilaterally (4 screws) in each of 4 cadavers using standard fluoroscopy, computer-assisted fluoroscopic image guidance, Iso-C3D image guidance, and electromagnetic fluoroscopic image guidance. Screw positions were analyzed by computerized tomography after instrumentation and assigned a score based on deviation from ideal screw position. RESULTS: The StealthStation with FluoroNav (Medtronic Surgical Navigation Technologies) appeared to provide the highest accuracy of all guidance techniques. This result was more accurate than standard fluoroscopy. CONCLUSIONS: Computer-assisted fluoroscopy based image navigation appears to be more accurate than standard fluoroscopy in placing these screws. However, errors may occur with all techniques. Further refinement in registration procedures may highly improve the accuracy of percutaneous screw placement in a variety of spinopelvic procedures.
Authors: Jörn Zwingmann; Gerhard Konrad; Elmar Kotter; Norbert P Südkamp; Michael Oberst Journal: Clin Orthop Relat Res Date: 2008-11-26 Impact factor: 4.176
Authors: M A König; S Hediger; J W Schmitt; T Jentzsch; K Sprengel; C M L Werner Journal: Eur J Trauma Emerg Surg Date: 2016-05-11 Impact factor: 3.693
Authors: Barbara M Dirhold; Mustafa Citak; Hesham Al-Khateeb; Carl Haasper; Daniel Kendoff; Christian Krettek; Musa Citak Journal: Curr Rev Musculoskelet Med Date: 2012-09
Authors: Josephine Berger-Groch; Marie Lueers; Johannes Maria Rueger; Wolfgang Lehmann; Darius Thiesen; Jan Philipp Kolb; Maximilian Johannes Hartel; Lars Gerhard Grossterlinden Journal: Eur J Trauma Emerg Surg Date: 2018-07-20 Impact factor: 3.693