Abstracts Posters SICOT-SOF meeting Gothenburg 2010 _2_

Poster
Topic: Navigation
Abstract number: 25985
COMPUTER-ASSISTED IMAGE-GUIDED TRANSPEDICULAR SCREW FIXATION
OF THE LUMBAR SPINE
Aleksander BELETSKIY, Andrey MAZURENKA, Sergey YURCHENKO
Belarussion Center of Traumatology and Orthopaedic Surgery, Minsk (BELARUS)
Introduction: Nowadays, transpedicular fixation is widely used in lumbar spine
surgery. However, along with the efficiency of the technique there remains the risk of
different complications using traditional control techniques of screw positioning
(fluoroscopy and anatomic landmark control). Using computer navigation systems
has turned into a solution of this problem. Navigation system minimizes and, if
skilfully handled, eliminates the risk of operational complications, connected with
wrong screws positioning. Using preoperational CT scans or intraoperative
fluoroscopy images of the spine this system allows to monitor instruments positioning
towards anatomic elements in real-time mode. Material and methods: 76 patients
underwent lumbar spine surgery using computer surgical navigation. In 65 cases
preoperational CT analysis data were used (FluoroMerge program), - in 10 of them -
intraoperational fluoroscopy data (FluoroNav program). All operated patients were
given a control post operational CT examination to determine the screws positioning.
Results: Correct screw positioning was determined in accordance with the degree of
damage of the arch root cortical plate. In all cases continuity of the arch root cortical
plate was not violated and screws positioning was considered to be sufficient.
Conclusions: Computer navigation is a modern technique that allows to position
transpedicular screws with great accuracy minimizing the risk of complications,
connected with wrong positioning of the latter mentioned. The system of computer
surgical navigation is a «passive» one. It does not surgeon’s manipulations, but it just
visualizes what the he does. Thus the final result depends on decisions made by the
surgeon.
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