Management of C1-2 traumatic fractures using an intraoperative 3D imaging-based navigation system

Research output: Contribution to journalArticle

16 Citations (Scopus)

Abstract

OBJECT: Fractures of C-1 and C-2 are complex and surgical management may be difficult and challenging due to the anatomical relationship sbetween the vertebrae and neurovascular structures. The aim of this study was to evaluate the role, reliability, and accuracy of cervical fixation using the O-arm intraoperative 3D image-based navigation system.

METHODS: The authors evaluated patients who underwent a navigation system-based surgery for stabilization of a fracture of C-1 and/or C-2 from August 2011 to August 2013. All of the fixation screws were intraoperatively checked and their position was graded.

RESULTS: The patient population comprised 17 patients whose median age was 47.6 years. The surgical procedures were as follows: anterior dens screw fixation in 2 cases, transarticular fixation of C-1 and C-2 in 1 case, fixation using the Harms technique in 12 cases, and occipitocervical fixation in 2 cases. A total of 67 screws were placed. The control intraoperative CT scan revealed 62 screws (92.6%) correctly placed, 4 (5.9%) with a minor cortical violation (

CONCLUSIONS: The use of a navigation system based on an intraoperative CT allows a real-time visualization of the vertebrae, reducing the risks of screw misplacement and consequent complications.

Original languageEnglish
Pages (from-to)128-133
Number of pages6
JournalJournal of Neurosurgery: Spine
Volume22
Issue number2
DOIs
Publication statusPublished - Feb 1 2015

Fingerprint

Spine
Population

Keywords

  • cervical fracture
  • IGS = image-guided system
  • O-arm
  • radiation dose
  • screw misplacement
  • spinal navigation
  • VA = vertebral artery

ASJC Scopus subject areas

  • Medicine(all)

Cite this

@article{5c4e93939eb941ff9ff12a031f7061bd,
title = "Management of C1-2 traumatic fractures using an intraoperative 3D imaging-based navigation system",
abstract = "OBJECT: Fractures of C-1 and C-2 are complex and surgical management may be difficult and challenging due to the anatomical relationship sbetween the vertebrae and neurovascular structures. The aim of this study was to evaluate the role, reliability, and accuracy of cervical fixation using the O-arm intraoperative 3D image-based navigation system.METHODS: The authors evaluated patients who underwent a navigation system-based surgery for stabilization of a fracture of C-1 and/or C-2 from August 2011 to August 2013. All of the fixation screws were intraoperatively checked and their position was graded.RESULTS: The patient population comprised 17 patients whose median age was 47.6 years. The surgical procedures were as follows: anterior dens screw fixation in 2 cases, transarticular fixation of C-1 and C-2 in 1 case, fixation using the Harms technique in 12 cases, and occipitocervical fixation in 2 cases. A total of 67 screws were placed. The control intraoperative CT scan revealed 62 screws (92.6{\%}) correctly placed, 4 (5.9{\%}) with a minor cortical violation (CONCLUSIONS: The use of a navigation system based on an intraoperative CT allows a real-time visualization of the vertebrae, reducing the risks of screw misplacement and consequent complications.",
keywords = "cervical fracture, IGS = image-guided system, O-arm, radiation dose, screw misplacement, spinal navigation, VA = vertebral artery",
author = "Francesco Costa and Alessandro Ortolina and Luca Attuati and Andrea Cardia and Massimo Tomei and Marco Riva and Luca Balzarini and Maurizio Fornari",
year = "2015",
month = "2",
day = "1",
doi = "10.3171/2014.10.SPINE14122",
language = "English",
volume = "22",
pages = "128--133",
journal = "Journal of Neurosurgery: Spine",
issn = "1547-5654",
publisher = "American Association of Neurological Surgeons",
number = "2",

}

TY - JOUR

T1 - Management of C1-2 traumatic fractures using an intraoperative 3D imaging-based navigation system

AU - Costa, Francesco

AU - Ortolina, Alessandro

AU - Attuati, Luca

AU - Cardia, Andrea

AU - Tomei, Massimo

AU - Riva, Marco

AU - Balzarini, Luca

AU - Fornari, Maurizio

PY - 2015/2/1

Y1 - 2015/2/1

N2 - OBJECT: Fractures of C-1 and C-2 are complex and surgical management may be difficult and challenging due to the anatomical relationship sbetween the vertebrae and neurovascular structures. The aim of this study was to evaluate the role, reliability, and accuracy of cervical fixation using the O-arm intraoperative 3D image-based navigation system.METHODS: The authors evaluated patients who underwent a navigation system-based surgery for stabilization of a fracture of C-1 and/or C-2 from August 2011 to August 2013. All of the fixation screws were intraoperatively checked and their position was graded.RESULTS: The patient population comprised 17 patients whose median age was 47.6 years. The surgical procedures were as follows: anterior dens screw fixation in 2 cases, transarticular fixation of C-1 and C-2 in 1 case, fixation using the Harms technique in 12 cases, and occipitocervical fixation in 2 cases. A total of 67 screws were placed. The control intraoperative CT scan revealed 62 screws (92.6%) correctly placed, 4 (5.9%) with a minor cortical violation (CONCLUSIONS: The use of a navigation system based on an intraoperative CT allows a real-time visualization of the vertebrae, reducing the risks of screw misplacement and consequent complications.

AB - OBJECT: Fractures of C-1 and C-2 are complex and surgical management may be difficult and challenging due to the anatomical relationship sbetween the vertebrae and neurovascular structures. The aim of this study was to evaluate the role, reliability, and accuracy of cervical fixation using the O-arm intraoperative 3D image-based navigation system.METHODS: The authors evaluated patients who underwent a navigation system-based surgery for stabilization of a fracture of C-1 and/or C-2 from August 2011 to August 2013. All of the fixation screws were intraoperatively checked and their position was graded.RESULTS: The patient population comprised 17 patients whose median age was 47.6 years. The surgical procedures were as follows: anterior dens screw fixation in 2 cases, transarticular fixation of C-1 and C-2 in 1 case, fixation using the Harms technique in 12 cases, and occipitocervical fixation in 2 cases. A total of 67 screws were placed. The control intraoperative CT scan revealed 62 screws (92.6%) correctly placed, 4 (5.9%) with a minor cortical violation (CONCLUSIONS: The use of a navigation system based on an intraoperative CT allows a real-time visualization of the vertebrae, reducing the risks of screw misplacement and consequent complications.

KW - cervical fracture

KW - IGS = image-guided system

KW - O-arm

KW - radiation dose

KW - screw misplacement

KW - spinal navigation

KW - VA = vertebral artery

UR - http://www.scopus.com/inward/record.url?scp=84927170750&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84927170750&partnerID=8YFLogxK

U2 - 10.3171/2014.10.SPINE14122

DO - 10.3171/2014.10.SPINE14122

M3 - Article

C2 - 25415483

AN - SCOPUS:84927170750

VL - 22

SP - 128

EP - 133

JO - Journal of Neurosurgery: Spine

JF - Journal of Neurosurgery: Spine

SN - 1547-5654

IS - 2

ER -