An intraoperative 3D image-based navigation error during cervical pedicle screw insertion.
Aged
Cervical Vertebrae
/ diagnostic imaging
Decompression, Surgical
/ adverse effects
Diagnostic Errors
/ prevention & control
Humans
Imaging, Three-Dimensional
/ methods
Intraoperative Complications
/ etiology
Male
Ossification of Posterior Longitudinal Ligament
/ diagnostic imaging
Pedicle Screws
Research Design
Spinal Canal
/ injuries
Surgery, Computer-Assisted
/ adverse effects
3D fluoroscopy
O-armTM
cervical pedicle screw
navigation
navigation error
Journal
Nagoya journal of medical science
ISSN: 2186-3326
Titre abrégé: Nagoya J Med Sci
Pays: Japan
ID NLM: 0412011
Informations de publication
Date de publication:
Nov 2020
Nov 2020
Historique:
entrez:
14
12
2020
pubmed:
15
12
2020
medline:
25
9
2021
Statut:
ppublish
Résumé
A 67-year-old man underwent posterior cervical decompression surgery for ossification of the posterior longitudinal ligament (OPLL) with fixation using cervical pedicle screws (CPSs) guided by intraoperative 3D image-based navigation. Intraoperatively, while creating the screw hole using the navigation probe, the virtual trajectory on the intraoperative navigation screen showed a 10-degree angle discrepancy in the axial plane depending on whether a probing force was or was not applied for making the hole. This was potentially caused by vertebra rotation and a bent probe. Consequently, the CPSs were placed more laterally than the ideal trajectory, which resulted in <2 mm lateral perforation to the foramen transversarium. There were no screw insertion-related perioperative complications. Based on this case, we conclude that navigation error during CPS insertion can occur even with intraoperative 3D image-based navigation. The risk of a bowed navigation probe caused by posterior cervical muscle and vertebra rotation should be considered, even with use of a navigation reference frame.
Identifiants
pubmed: 33311810
doi: 10.18999/nagjms.82.4.799
pmc: PMC7719458
doi:
Types de publication
Case Reports
Langues
eng
Sous-ensembles de citation
IM
Pagination
799-805Déclaration de conflit d'intérêts
None of the authors have a conflict of interest to declare. Funding was from institutional sources only.
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