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Research ArticleFull Length Article
Open Access

Pedicle violation and Navigational errors in pedicle screw insertion using the intraoperative O-arm: A preliminary report

Jacob E. Mathew, Kelvin Mok and Benoit Goulet
International Journal of Spine Surgery January 2013, 7 e88-e94; DOI: https://doi.org/10.1016/j.ijsp.2013.06.002
Jacob E. Mathew
aDepartment of Orthopedics, Montreal General Hospital, Montreal, Quebec, Canada
MBBS MCh
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  • For correspondence: jacob.mathew@mail.mcgill.ca
Kelvin Mok
bNeuronavigation, Montreal Neurological Institute, Montreal, Quebec, Canada
MEng
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Benoit Goulet
cNeurosurgery, Montreal Neurological Institute, Montreal, Quebec, Canada
MD
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Article Figures & Data

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  • Fig. 1
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    Fig. 1

    (A) Axial angle on the O-Arm images. The arrow represents the midsagittal plane of L4, which is defined as 0°. The planned screw makes a 13.1° angle with the midsagittal plane of L4. (B) Axial angle on the postoperative images. The actual screw made 11.2° angle with the midsagittal plane of L4. (Color version of figure is available online.)

  • Fig. 2
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    Fig. 2

    (A) Sagittal angle on the O-Arm images. The arrow is the superior end plate of L4 defined as 0°. The planned screw makes a 10.1° angle with the end plate of L4. (B) Sagittal angle on the postoperative images. The actual screw makes a 10.7° angle with the end plate of L4. (Color version of figure is available online.)

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    Fig. 3

    Shows an example of anterolateral perforation. The adjacent image shows the planned L5 trajectory almost parallel to the midline sagittal vertebral axis. The triangle-shaped L5 body and proximity of the planned screw to the cortical margin can be noted. (Color version of figure is available online.)

Tables

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    Table

    The planned angle and the postoperative angle for each level in axial and sagittal planes. The mean navigational error in both planes is shown in column 4 and column 7. Standard deviation in parentheses

    LevelAxialSagittal
    Planned anglePostop angleNavigational errorPlanned anglePostop angleNavigational error
    RL410.4° (±2.8)10.5° (±2.8)1.8° (±1.5)11.4° (±3.2)11.1° (±2.7)2.1° (±1.6)
    LL49.9° (±3.9)10.3° (±3.2)2.3° (±1.7)9.4° (±3.1)10.7° (±3.9)3.6° (±2.5)
    L4 10.2° (±3.4)10.4°(±2.9) 2.1° (±1.6)10.3° (±3.3)10.9° (±3.3) 2.8° (±2.1)
    RL58.4° (±3.1)8.0° (±3.4)3.4° (±1.8)2.6° (±3.6)2.1° (±5.5)3.6° (±2.9)
    LL57.2° (±3.5)7.4° (±2.7)2.2° (±1.8)0.8° (±4.1)0.8° (±5.4)2.9° (±2.4)
    L5 7.8°(±3.3)7.7° (±3.1) 2.7° (±1.9)1.6° (±3.9)0.6° (±5.6) 3.2° (±2.6)
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International Journal of Spine Surgery
Vol. 7
1 Jan 2013
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Pedicle violation and Navigational errors in pedicle screw insertion using the intraoperative O-arm: A preliminary report
Jacob E. Mathew, Kelvin Mok, Benoit Goulet
International Journal of Spine Surgery Jan 2013, 7 e88-e94; DOI: 10.1016/j.ijsp.2013.06.002

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Pedicle violation and Navigational errors in pedicle screw insertion using the intraoperative O-arm: A preliminary report
Jacob E. Mathew, Kelvin Mok, Benoit Goulet
International Journal of Spine Surgery Jan 2013, 7 e88-e94; DOI: 10.1016/j.ijsp.2013.06.002
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Keywords

  • O-arm
  • Computer-assisted navigation
  • Clinical accuracy
  • Navigational accuracy
  • pedicle screw

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