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72. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC)
Joint Meeting mit der Polnischen Gesellschaft für Neurochirurgie

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

06.06. - 09.06.2021

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Clinical efficiency and quality of operating room-based sliding gantry CT as compared to mobile cone-beam CT-based navigated pedicle screw placement – an observational cohort study on 853 patients and 6733 screws

Klinische Effizienz und Qualität des OP-basierten sliding gantry CTs im Vergleich zum mobilen cone-beam CT für die navigierte Anlage von Pedikel-Schrauben – eine Observations-Kohorten-Studie an 853 Patienten und 6733 Schrauben

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  • presenting/speaker Sebastian Ille - Department of Neurosurgery, Technical University of Munich, School of Medicine, Klinikum rechts der Isar, München, Deutschland
  • Lea Baumgart - Department of Neurosurgery, Technical University of Munich, School of Medicine, Klinikum rechts der Isar, München, Deutschland
  • Bernhard Meyer - Department of Neurosurgery, Technical University of Munich, Germany, School of Medicine, Klinikum rechts der Isar, München, Deutschland
  • Sandro Krieg - Department of Neurosurgery, Technical University of Munich, School of Medicine, Klinikum rechts der Isar, München, Deutschland

Deutsche Gesellschaft für Neurochirurgie. 72. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit der Polnischen Gesellschaft für Neurochirurgie. sine loco [digital], 06.-09.06.2021. Düsseldorf: German Medical Science GMS Publishing House; 2021. DocP119

doi: 10.3205/21dgnc407, urn:nbn:de:0183-21dgnc4076

Published: June 4, 2021

© 2021 Ille et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.

Outline

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Objective: Today, multiple solutions for navigation-guided pedicle screw placement are available. For the present study, we analyzed the efficiency of an operating room (OR)-based sliding-gantry CT (ORCT) and a mobile cone-beam CT (CBCT)-based approach for spinal instrumentation.

Methods: We analyzed all patients who underwent ORCT-based or CBCT-based pedicle screw placement for spinal instrumentation at our department between 11/2015 and 01/2020.

Results: Intra- and postoperative complications as well as number of navigated screws and levels per case did not differ between the two groups. Although the accuracy of screw placement according to Gertzbein-Robbins classification did not differ between the two groups, more screws had to be revised intraoperatively in the CBCT group (ORCT: 98, 2.8% vs. CBCT: 128, 4.0%; p=0.0081).

The median time of patients inside the OR (Entry – Exit) was significantly shorter for the ORCT group (ORCT: median, [95% CI] 237.5, [247.8, 264.3] min, CBCT: 267, [274.4, 291.5] min; p<0.0001) based on shorter times for Positioning - Incision (ORCT: 17, [18.1, 19.9] min, CBCT: 32, [32.2, 35.5] min; p<0.0001) and Suture - Exit (ORCT: 22, [23.6, 26.1] min, CBCT: 25.5, [27.5, 30.7] min; p<0.0001).

Conclusion: The present results show that the choice of assistive technology for navigated pedicle screw placement has significant impact on standard spine procedures even in a high-volume spine center. Particularly with regard to cost-effectiveness and the duration of surgeries, the shorter time needed for preparation and de-positioning in the ORCT group made the main difference, while the quality of accuracy was even higher.