gms | German Medical Science

Deutscher Kongress für Orthopädie und Unfallchirurgie (DKOU 2016)

25.10. - 28.10.2016, Berlin

Navigation assisted anterior screw fixation of a Type II dens axis fracture using a hybrid operating room

Meeting Abstract

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  • presenting/speaker Vaclav Cink - Neurochirurgie, St.Gertrauden KH Berlin, Berlin, Germany
  • Martin Merkle - Neurochirurgie, St.Gertrauden KH Berlin, Berlin, Germany
  • Jan Kaminsky - Neurochirurgie, St.Gertrauden KH Berlin, Berlin, Germany

Deutscher Kongress für Orthopädie und Unfallchirurgie (DKOU 2016). Berlin, 25.-28.10.2016. Düsseldorf: German Medical Science GMS Publishing House; 2016. DocPO26-1300

doi: 10.3205/16dkou731, urn:nbn:de:0183-16dkou7310

Veröffentlicht: 10. Oktober 2016

© 2016 Cink et al.
Dieser Artikel ist ein Open-Access-Artikel und steht unter den Lizenzbedingungen der Creative Commons Attribution 4.0 License (Namensnennung). Lizenz-Angaben siehe http://creativecommons.org/licenses/by/4.0/.


Gliederung

Text

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.