@article{oai:nagoya.repo.nii.ac.jp:00030986,
 author = {Nakashima, Hiroaki and Ishikawa, Yoshimoto and Ando, Kei and Kobayashi, Kazuyoshi and Ishiguro, Naoki and Imagama, Shiro},
 issue = {4},
 journal = {Nagoya Journal of Medical Science},
 month = {Nov},
 note = {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.},
 pages = {799--805},
 title = {An intraoperative 3D image-based navigation error during cervical pedicle screw insertion},
 volume = {82},
 year = {2020}
}