gms | German Medical Science

Objective: Navigated screw placement in spine surgery is important in cases of complex deformity, previous surgery, or in cases of destabilizing spinal tumors. In this study, we are presenting our experience with the feasibility and accuracy of the electromagnetic navigation system.

Methods: Twenty-five patients were operated for spinal fixation in our institution. This cohort included 23 patients for lumbar fixation and two patients for dorsal fixation. We placed 120 screws under electromagnetic navigation (Fiagon Navigation System). The accuracy of the navigation was tested intraoperatively using anatomical landmarks and fluoroscopy and after surgery using computer tomography.

Results: The setup of the navigation was possible for spinal surgery. Surface registration was successful and relatively fast in all cases. We did not observe interference from the instruments in the surgical field. Placement of the screws was successful in all patients. The entry points were precisely corresponding to the anatomical landmark. However in 3 screws, the trajectory in the postoperative CT was lateral than what shown by the navigator.

Conclusion: The electromagnetic navigation in feasible for spinal surgery with small setup and rapid registration. It showed acceptable accuracy and accordingly it can decrease the frequency of using fluoroscopy.

Figure 1 [Fig. 1]