Transcutaneous transpedicular osteosynthesis of lumbar spine using mobile operative X-ray unit О-Ат in coincidence with navigation system

Introduction. We presented the first experience in Russia of the usage of mobile operational X-ray unit O-Arm combined with navigation station Stealth Station Treon Plus (Medtronic Navigation) during transcutaneous transpedicular osteosynthesis of lumbar spine. Objective - to estimate the possibility for the usage of mobile operational X-ray unit O-Arm combined with navigation station during transcutaneous transpedicular osteosynthesis of lumbar spine and comparison of this method with routine intraoperative roentgenoscopy. Material and methods. We analyzed the surgical treatment outcomes at 168 patients (72 men and 96 women) operated on in spinal neurosurgical department of FFSI «Federal; Neurosurgical Center» (Tyumen, RF) from April 2011 till August 2012. Results. The accurate positioning of transpedicular screws was achieved in 99,4% of patients during usage of X-ray unit O-Arm combined with navigation station (2d group, 114 patients, 530 screws), that was much more better comparing with the usage of routine methods of roentgenoscopy with the help of C-arch (1st group, 54 patients, 258 screws) where the accuracy of positioning was only 86,8%. The mean duration of operation was 195,4±36,5 min and 269,8±41,3 min in 2d and 1st groups respectively (P<0,05). The decreasing of operation duration in 2d group with О-Arm was related to cutting time of screws positioning from 9,2±2,7 min (during usage of C-arch) till 5,3±1,7 min (P<0,05) and decrease of the number of provisional procedures for repeated roentgenoscopic control examinations comparing with the 1st group. Conclusion. The percutaneous transpedicular osteosynthesis with the usage of mobile operational X-ray unit O-Arm combined with navigation station is the safe and effective method of surgical treatment which allows providing the high accuracy of transpedicular screws positioning as well as decreasing the duration of surgical intervention comparing with routine methods of roentgenoscopy.

транспедикулярный остеосинтез, O-Arm, нейронавигация, transpedicular osteosynthesis, O-Arm, neuronavigation

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