Evaluation of accuracy of computed topographic- based navigation assisted pedicle screw placement in thoracolumbar spine fracture

Mukesh Dhruw, Pravin Kumar Jangde, Surendra Kanwar


Background: Although pedicle screw fixation is a well-established technique for the thoracolumbar spine fracture, but the screw placement in the thoracolumbar spine is more challenging because more complex 3D anatomy. Incorrect placement of pedicle screws may lead to neurovascular injury, so the accuracy of pedicular screw placement is very crucial task. CT based navigation devices may allow surgeons a safe and more accurate method for placing pedicle screws with no radiation exposure intraoperative.

Method: A Computed topographic (CT) based image guided navigation system was used for pedicle screw insertion. The accuracy of the pedicle screw placement was analyzed According to ‘Learch and Wiesners classification’ and ‘Heary classification’ for pedicle screw malplacement with a review of postoperative radiograph and CT scan image.

Result: Under the guidance of CT based navigation 52 pedicle screws were inserted, out of which 02 pedicular screw shows lateral pedicle cortex breach.

Conclusion: The accuracy of pedicle screw placement is crucial for thoracolumbar spine fracture fixation. The placement of pedicle screws can be done more accurately and safely with the aid of a CT-based navigation system. Furthermore, this opens the possibility for surgeons to reduce radiationexposure by eliminating the need for intra - operative fluoroscopy.


Navigation, Thoracolumbar spine fracture, Pedicular screw, Unstable fracture, Computed tomography

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