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Instrumented spinal stabilisation - review of navigated versus x-ray guided techniques and impact on surgeons training
Author(s): ,
A. Budu
Affiliations:
Royal Hallamshire Hospital, Sheffield, United Kingdom
,
M. Ivanov
Affiliations:
Royal Hallamshire Hospital, Neurosurgery, Sheffield, United Kingdom
Duncan Henderson
Affiliations:
Royal Hallamshire Hospital, Sheffield,UK
EANS Academy. Budu A. Oct 21, 2018; 225975; EP2067
Dr. Alexandru Budu
Dr. Alexandru Budu
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Abstract
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Accurate placement of the spinal instrumentation represents an important step of successful spinal surgery. Spinal instrumentation can be inserted using free-hand, x-ray guided or navigation guided techniques.
Navigation-guided spinal instrumentation is becoming more and more popular for several reasons: improved accuracy of pedicle screw placement, decreased rate of complications, neurological damage and revision surgery, but also reduced radiation exposure to the surgical team. Nevertheless, a group of spinal surgeons consider the benefit of navigation surgery questionable.
We performed a retrospective study and reviewed all the spinal instrumented cases performed in our unit between January 2011 and December 2015 . During this 5 year period, 145 spinal instrumented cases were recorded, with a total of 678 screws implanted, out of which 204 were placed using navigation. The cases included instrumented fusion at all spinal segments (cervical, thoracic and lumbar) for various conditions starting with two-level stabilisation in spondylolisthesis, and ending with multi-level thoracic or cervical instrumentation. The accuracy of screw placement in navigated versus x-ray guided procedures has been assessed. alongside with further data, such as operating surgeon experience and case complexity. Final data analysis revealed that there is a significant statistical difference between the two techniques, with a lower rate of complications for the navigation based procedures.Furthermore, navigation use had a drastic impact on the surgeons learning curve and proofed safer.

We will review the current literature on this topic, and the way it has changed and affect recent spinal practice
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