Clinical and Radiologic Outcomes of Thoracolumbar Fusions Using Intraoperative CT Guidance and Stereotactic Navigation in a Spinal Trauma Population: An Analysis of 58 Patients

Clinical Spine Surgery : a Spine Publication
Joseph S DominoPaul M Arnold

Abstract

Retrospective review of prospectively collected single-institution database. To analyze the clinical and radiographic outcomes of posterior thoracolumbar fusions using intraoperative computed tomography (CT)-guidance and stereotactic navigation in thoracolumbar spinal trauma. Pedicle screw instrumentation is utilized for stabilization in thoracolumbar fusions. Suboptimal placement may lead to neurovascular complications, pseudarthrosis, postoperative pain, and the need for revision surgery. Image-guided spinal surgery is commonly used to improve accuracy, particularly for complex anatomy such as encountered with traumatic fractures. We retrospectively identified 58 patients undergoing posterior thoracolumbar fusions using intraoperative CT and stereotactic navigation for traumatic fractures from 2010 to 2017 at a single institution. Pedicle screw accuracy, realignment, clinical outcomes, and ease of use were retrospectively reviewed. Accuracy was assessed on postplacement or postoperative CT. Breach grades included: grade 1 (<2 mm), grade 2 (2-4 mm), and grade 3 (>4 mm). A total of 58 patients were identified having undergone 58 operations, which involved placement of 519 pedicle screws. Traumatic fracture patterns and levels o...Continue Reading

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