An Investigation of Spinal Surgery Using a Navigation System

Abstract

We report the use of a navigation system for spinal surgery, with details of its utilities and problems. Between April 2004 and June 2009, we treated 28 cases using a navigation system. The average patient age at the time of surgery was 49 years (range 10 to 86 years). Cervical spine surgery was undertaken in 16 cases, and thoracolumbar spine surgery in 12. The diagnoses were RA (3 cases), kyphosis (6 cases), spondylolisthesis (2 cases), trauma (10 cases), and others (5 cases). All patients had marked bone destruction or bone deformity.
The mean operation time was 268 minutes for cervical surgery and 238 minutes for thoracolumbar surgery, and the mean blood loss was 282 ml and 279 ml, respectively. We used 81 cervical screws in 13 cases, and 68 thoracolumbar screws in 12 cases. Seventy-eight of the 81 cervical screws were graded in Group 1, and 3 were graded in Grade 2. Two of the 68 thoracolumbar screws were graded in each of A-1, A-2, and A-3, respectively, and 1 was graded in C-2. Many of the misplaced screws showed lateral perforation, perhaps due to spinal rotation when placing the screws by pushing the entry point of the spinal column.
We were able to insert the screws safely using the navigation system. Especially for cases with marked deformity, we were able to control the screws with careful preoperative planning.