Artikel
Spinal navigation: Accepted standard of care? Current situation in Germany
Spinale Navigation: ein akzeptierter Behandlungsstandard? Gegenwärtige Situation in Deutschland
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Autoren
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J. Schröder
- Klinik und Poliklinik für Neurochirurgie, Universitätsklinikum Münster
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H. Wassmann
- Klinik und Poliklinik für Neurochirurgie, Universitätsklinikum Münster
| Veröffentlicht: | 8. Mai 2006 |
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Gliederung
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Objective: In contrast to cranial neuro-navigation, which successfully made its way as routine intra-operative tool, there is still al lot of debate about spinal navigation as an aid for the insertion of pedicle screws. Opinions range from not useful at all to malpractice if not using it. The aim of our investigation was to gain data about the availability of spinal navigation and support a common opinion under German neurosurgeons about their usefulness.
Methods: We present the results of an enquiry of the commission for technical standards of the German Neurosurgical Society about the use of intra-operative computerised spinal navigation.
Results: Of the 128 neurosurgical departments 107 (84%) responded, 57 (53%) are equipped with a spinal navigation device, 12 (11%) can use a spinal navigation equipment together with other departments and 38 (36%) do not have spinal navigation. Of the departments not equipped with spinal navigation up to now 58% would like to have it and 42% not. The opinion that spinal navigation enhances safety in introducing pedicle screws is shared by 52 responders (49%), 15 (14%) are not sure and 40 (37%) answered negative. The statement “spinal navigation should be mandatory for placing pedicle screws” is supported by only 3 responders, 3 are not sure and 101 (94%) disagreed. The statement “insertion of pedicle screws without navigation is medical malpractice” is supported by only one responder and one is not sure. An overwhelming majority of 105 responders (98%) reject this statement.
Conclusions: Spinal navigation as an aid for the implantation of pedicle screws is still far away from being considered common practice. Most pedicle screws are still inserted conventionally. Although nearly 50% of the German neurosurgeons believe in the fact that spinal navigation could enhance safety in the placement of pedicle screws, they clearly reject efforts to make spinal navigation mandatory. Considering the placement of pedicle screws without spinal navigation a medical malpractice is a single person’s opinion, not shared by the German neurosurgical community.
