• Ya-jun Liu, Wei Tian, Bo Liu, Qin Li, Lin Hu, Zhi-yu Li, Qiang Yuan, Yong-gang Xing, Yong-qing Wang, and Yu-zhen Sun.
• Department of Spine Surgery, Beijing Jishuitan Hospital, Beijing 100035, China.
• Zhonghua Wai Ke Za Zhi. 2005 Oct 15;43(20):1328-30.

ObjectiveTo evaluate the feasibility and accuracy of cervical spine pedicle screw fixation assisted by X-ray fluoroscopy and CT-based navigation system.Methods145 cervical pedicle screws were placed assisted by X-ray fluoroscopy and 159 cervical pedicle screws were placed assisted by CT-based navigation system. Screw positions were evaluated by postoperative CT scans or C-arm X-ray 3 dimensional reconstruction.ResultsIn the computer- assisted group, 155 (97.5%) screws were found completely within their pedicles compared with 133 (91.7%) correctly placed screws in the X-ray assisted group (P < 0.05). The process of navigation investigated in twenty patients showed that the mean time for registration and surface matching was 3.5 (range from 2 to 8 minutes) minutes and the mean time for screw-marker insertion was 2 (range from 1 to 3.5 minutes) minutes with the mean position deviation 0.31 mm (0.12-0.56 mm) per screw. Only twice C-arm fluoroscopy were performed to verify the accuracy of one screw position intraoperatively. No severe complications like neurovascular lesion occurred in both groups.ConclusionCT-based navigation system can increase the accuracy of cervical pedicle screw implantation significantly.

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