Martin Mohammed Marzouk1,2, Yama Afghanyar3, Mark Mahmoud Marzouk4, Sarah Halima Boussouf5, Philipp Hartung6, Marcus Richter6. 1. Spine Center, St. Josefs-Hospital Wiesbaden, Beethovenstraße 20, 65189, Wiesbaden, Hesse, Germany. martin.marzouk@yahoo.com. 2. , Alt Oberliederbach 1, 65835, Liederbach, Hesse, Germany. martin.marzouk@yahoo.com. 3. Center for Orthopaedic and Trauma Surgery, St. Josefs-Hospital Wiesbaden, Beethovenstraße 20, 65189, Wiesbaden, Hesse, Germany. 4. Justus-Liebig-Universität Gießen, Ludwigstraße 23, 35390, Gießen, Hesse, Germany. 5. Department of Internal Medicine, Hospital of Hofheim, Lindenstraße 10, 65719, Hofheim, Hesse, Germany. 6. Spine Center, St. Josefs-Hospital Wiesbaden, Beethovenstraße 20, 65189, Wiesbaden, Hesse, Germany.
Abstract
PURPOSE: This retrospective matched case-control study was conducted to compare two CT based surgery techniques for navigated screw placement in spinal surgery, whether a reduction of radiation exposure and surgery time could be achieved. METHODS: We matched cases treated with an intraoperative CT (iCT), regarding the type and number of implants, with cases treated with a preoperative CT (pCT) of one main surgeon. Outcome measures were radiation exposure due to intraoperative control x-rays, radiation exposure due to CT images, and the duration of surgery. RESULTS: The required radiation exposure could be significantly reduced in the iCT group. For the intraoperative control X-rays by 69% (median (MED) 88.50/standard deviation (SD) 107.84 and MED 286.00/SD 485.04 for iCT and pCT respectively-in Gycm2; p < 0.001) and for the CT examinations by 25% (MED 317.00/SD 158.62 and MED 424.50/SD 225.04 for iCT and pCT respectively-in mGycm; p < 0.001) with no significant change in surgery time. The correlation between the number of segments fused and the necessary surgery time decreased significantly for the iCT group (Pearson product-moment-correlation: r = 0.569 and r = 0.804 for iCT and pCT respectively; p < 0.05). CONCLUSION: The results show that spinal navigation using an intraoperative CT with automatic registration compared to a preoperative CT and intraoperative manual surface registration, allows a significant reduction of radiation exposure, without prolonged surgery time. A significant benefit regarding cut-to-suture-time can be gained with surgeries of a larger scale.
PURPOSE: This retrospective matched case-control study was conducted to compare two CT based surgery techniques for navigated screw placement in spinal surgery, whether a reduction of radiation exposure and surgery time could be achieved. METHODS: We matched cases treated with an intraoperative CT (iCT), regarding the type and number of implants, with cases treated with a preoperative CT (pCT) of one main surgeon. Outcome measures were radiation exposure due to intraoperative control x-rays, radiation exposure due to CT images, and the duration of surgery. RESULTS: The required radiation exposure could be significantly reduced in the iCT group. For the intraoperative control X-rays by 69% (median (MED) 88.50/standard deviation (SD) 107.84 and MED 286.00/SD 485.04 for iCT and pCT respectively-in Gycm2; p < 0.001) and for the CT examinations by 25% (MED 317.00/SD 158.62 and MED 424.50/SD 225.04 for iCT and pCT respectively-in mGycm; p < 0.001) with no significant change in surgery time. The correlation between the number of segments fused and the necessary surgery time decreased significantly for the iCT group (Pearson product-moment-correlation: r = 0.569 and r = 0.804 for iCT and pCT respectively; p < 0.05). CONCLUSION: The results show that spinal navigation using an intraoperative CT with automatic registration compared to a preoperative CT and intraoperative manual surface registration, allows a significant reduction of radiation exposure, without prolonged surgery time. A significant benefit regarding cut-to-suture-time can be gained with surgeries of a larger scale.
Authors: Jens Geerling; Thomas Gösling; Anna Gösling; Gil Ortega; Daniel Kendoff; Musa Citak; Christian Krettek; Tobias Hüfner Journal: Comput Aided Surg Date: 2008-05
Authors: Kaissar Farah; Pierre Coudert; Thomas Graillon; Benjamin Blondel; Henry Dufour; Olivier Gille; Stephane Fuentes Journal: World Neurosurg Date: 2018-07-03 Impact factor: 2.104