2024-03-29T06:11:45Z
https://nagoya.repo.nii.ac.jp/oai
oai:nagoya.repo.nii.ac.jp:00030986
2023-11-16T02:45:20Z
499:508:509:2601
An intraoperative 3D image-based navigation error during cervical pedicle screw insertion
Nakashima, Hiroaki
Ishikawa, Yoshimoto
Ando, Kei
Kobayashi, Kazuyoshi
Ishiguro, Naoki
Imagama, Shiro
open access
Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International
cervical pedicle screw
navigation
O-armTM
3D fluoroscopy
navigation error
A 67-year-old man underwent posterior cervical decompression surgery for ossification of the posterior longitudinal ligament (OPLL) with fixation using cervical pedicle screws (CPSs) guided by intraoperative 3D image-based navigation. Intraoperatively, while creating the screw hole using the navigation probe, the virtual trajectory on the intraoperative navigation screen showed a 10-degree angle discrepancy in the axial plane depending on whether a probing force was or was not applied for making the hole. This was potentially caused by vertebra rotation and a bent probe. Consequently, the CPSs were placed more laterally than the ideal trajectory, which resulted in <2 mm lateral perforation to the foramen transversarium. There were no screw insertion-related perioperative complications. Based on this case, we conclude that navigation error during CPS insertion can occur even with intraoperative 3D image-based navigation. The risk of a bowed navigation probe caused by posterior cervical muscle and vertebra rotation should be considered, even with use of a navigation reference frame.
Nagoya University Graduate School of Medicine, School of Medicine
2020-11
eng
departmental bulletin paper
VoR
https://doi.org/10.18999/nagjms.82.4.799
http://hdl.handle.net/2237/00033171
https://nagoya.repo.nii.ac.jp/records/30986
10.18999/nagjms.82.4.799
http://www.med.nagoya-u.ac.jp/medlib/nagoya_j_med_sci/824.html
2186-3326
0027-7622
Nagoya Journal of Medical Science
82
4
799
805
https://nagoya.repo.nii.ac.jp/record/30986/files/20_Nakashima.pdf
application/pdf
3.2 MB
2020-11-26