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European Spine Journal

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01-06-2016 | Original Article

Interest of intra-operative 3D imaging in spine surgery: a prospective randomized study

Authors: Sébastien Ruatti, C. Dubois, E. Chipon, G. Kerschbaumer, M. Milaire, A. Moreau-Gaudry, J. Tonetti, Ph. Merloz

Published in: European Spine Journal | Issue 6/2016

Abstract

Purpose

We report a single-center, prospective, randomized study for pedicle screw insertion in opened and percutaneous spine surgeries, using a computer-assisted surgery (CAS) technique with three-dimensional (3D) intra-operative images intensifier (without planification on pre-operative CT scan) vs conventional surgical procedure.

Material and method

We included 143 patients: Group C (conventional, 72 patients) and Group N (3D Fluoronavigation, 71 patients). We measured the pedicle screw running time, and surgeon’s radiation exposure. All pedicle runs were assessed according to Heary by two independent radiologists on a post-operative CT scan.

Results

3D Fluoronavigation appeared less accurate in percutaneous procedures (24 % of misplaced pedicle screws vs 5 % in Group C) (p = 0.007), but more accurate in opened surgeries (5 % of misplaced pedicle screws vs 17 % in Group C) (p = 0.025). For one vertebra, the average surgical running time reached 8 min in Group C vs 21 min in Group N for percutaneous surgeries (p = 3.42 × 10⁻⁹), 7.33 min in Group C vs 16.33 min in Group N (p = 2.88 × 10⁻⁷) for opened surgeries. The 3D navigation device delivered less radiation in percutaneous procedures [0.6 vs 1.62 mSv in Group C (p = 2.45 × 10⁻⁹)]. For opened surgeries, it was twice higher in Group N with 0.21 vs 0.1 mSv in Group C (p = 0.022).

Conclusion

The rate of misplaced pedicle screws with conventional techniques was nearly the same as most papers and a little bit higher with CAS. Surgical running time and radiation exposure were consistent with many studies. Our work hypothesis is partially confirmed, depending on the type of surgery (opened or closed procedure).

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Title: Interest of intra-operative 3D imaging in spine surgery: a prospective randomized study
Authors: Sébastien Ruatti
C. Dubois
E. Chipon
G. Kerschbaumer
M. Milaire
A. Moreau-Gaudry
J. Tonetti
Ph. Merloz
Publication date: 01-06-2016
Publisher: Springer Berlin Heidelberg
Published in: European Spine Journal / Issue 6/2016
Print ISSN: 0940-6719
Electronic ISSN: 1432-0932
DOI: https://doi.org/10.1007/s00586-015-4141-5

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Interest of intra-operative 3D imaging in spine surgery: a prospective randomized study

Abstract

Purpose

Material and method

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Material and method

Results

Conclusion

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