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Improved accuracy of computer-assisted cervical pedicle screw insertion

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タイトル: Improved accuracy of computer-assisted cervical pedicle screw insertion
著者: Kotani, Yoshihisa 著作を一覧する
Abumi, Kuniyoshi 著作を一覧する
Ito, Manabu 著作を一覧する
Minami, Akio 著作を一覧する
キーワード: computer-assisted surgery
pedicle screw fixation
cervical spine
発行日: 2003年10月
出版者: American Association of Neurological Surgeons
誌名: Journal of Neurosurgery : Spine
巻: 99
号: 3
開始ページ: 257
終了ページ: 263
抄録: OBJECT: The authors introduce a unique computer-assisted cervical pedicle screw (CPS) insertion technique used in conjunction with specially modified original pedicle screw insertion instruments. The accuracy of screw placement as well as surgery-related outcome and complication rates were compared between two groups of patients: those in whom a computer-assisted and those in whom a conventional manual insertion technique was used. METHODS: The screw insertion guiding system consisted of a modified awl, probe, tap and a screwdriver specially designed for a computer-assisted CPS insertion. Using this system, real-time instrument/screw tip information was three dimensionally identified in each step of screw insertion. Seventeen patients underwent CPS fixation in which a computer-assisted surgical navigation system was used. The cervical disorders consisted of spondylotic myelopathy with segmental instability or kyphosis, metastatic spinal tumor, rheumatoid spine, and postlaminectomy kyphosis. The rate of pedicle wall perforation was significantly lower in the computer-assisted group than that in the other group (1.2 and 6.7%, respectively; p 0.05). The screw trajectory in the horizontal plane was significantly closer to the anatomical pedicle axis in the computer-assisted group compared with the manual insertion group (p 0.05). This factor significantly reduced the incidence of screw perforation laterally. Complications such as neural damage or vascular injury were not demonstrated in the computer-assisted group (compared with 2% in the manual insertion treatment group). The overall surgery-related outcome was satisfactory. CONCLUSIONS: In contrast to the previously reported computer-assisted technique, our CPS insertion technique provides real-time three-dimensional instrument/screw tip information. This serves as a powerful tool for safe and accurate pedicle screw placement in the cervical spine.
Rights: The final version of the paper was published in Journal of Neurosurgery:Spine, vol. 99-3. For reuse of any of the materials, including editorial copy, figures, or tables please contact the Journal of Neurosurgery at
資料タイプ: article (author version)
出現コレクション:雑誌発表論文等 (Peer-reviewed Journal Articles, etc)

提供者: 小谷 善久


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