Artikel
Navigation assisted anterior screw fixation of a Type II dens axis fracture using a hybrid operating room
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Veröffentlicht: | 10. Oktober 2016 |
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Gliederung
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Objectives: Fractures of the Dens axis are often complex and a sufficient osteoynthesis may be challenging. The aim of this study was to prove the suitability of using a hybrid operating room and navigation Face-Mask-Referencing and Tracking device for anterior screw positioning in C2.
Methods: For the intraoperative CT like imaging we used a Artis Zeego operating room by Siemens, for navigation we used the Stryker Navigation System and a Face-Mask-Referencing and Tracking device. The patient was a 76y old woman who suffered a Type II Dens fracture from a falling trauma. The surgery was performed in supine position. After fracture reposition and positioning of the head in a rigid carbon fixation we attached a Face-Mask-Referencing and Tracking device. From this moment on, no movement of the patient or the face mask should be undergone. In this potion we drove a scan with the hybrid imaging system and transferred the CT-like Data to the Navigation system. After usual ventral anterior surgical access to the dens we referenced a rigid drillwire. To avoid injury we controlled the screw positioning stepwise by x-ray.
Results: The navigation was absolutely accurate and optimal screw positioning could be undergone within the first try. No problems with referencing or intraoperative navigation drift occured. In the CT-like intraoperative imaging a sufficient osteosynthesis could be proven.
Conclusions: The use of a hybrid operating room and navigation Face-Mask-Referencing and Tracking device for anterior screw positioning in C2 is a save and sufficient procedure and could allow to reduce x-ray radiation load of the surgeon and the patient. Due to the CT-like intraoperative imaging, revision and consequent complications and misplacemant of screws or osteosynthesis insuffitiency can be avoided.