Compared with other cervical spine stabilization techniques, LMS fixation has been proven to be effective and safe. Our approach was midline posterior with subperiosteal paraspinal muscle dissection to the lateral edge of the lateral masses. A total of subaxial cervical LMS were inserted in 40 consecutive patients. Abstract Objective Cervical spine can be stabilized by different techniques. We used CT scan-based navigation, and the images were uploaded to the Stryker navigation system preoperatively. During the insertion of the subaxial cervical LMS, the 3D navigation system was used for 20 patients, and the freehand technique was used for the remaining 20 patients.
Screw malposition was less in the 3D navigation group compared with the freehand group and was statistically significant. Compared with other cervical spine stabilization techniques, LMS fixation has been proven to be effective and safe. The inclusion criteria were age 18 years and above, fracture of the subaxial cervical spine or cervical degenerative disc disease associated with myelopathy as an indication, at least 1 level of LMS fixation 2 vertebrae from C3 to C7, and patients with extension of instrumentation to occiput or the thoracic spine. The CT-based navigation systems help the spine surgeons to accurately place spinal instrumentation pedicle screws, LMS, and interbody fusions. The CT scan analysis showed that the screw breakage, screw pull-outs, and screw loosening were the same between the two groups. Registration in the navigation system can be either single-time multilevel registration or the level-by-level registration method. We identified the levels using a cross-table ray and hooked the navigation array to either the distal or proximal exposed spinous processes. We used a single-time multilevel registration and checked our accuracy at each level using the spinous process and the facet joint as a mark to decrease the operative time Fig. LMF was less in the 3D navigation group but statistically insignificant. We used CT scan-based navigation, and the images were uploaded to the Stryker navigation system preoperatively. Abstract Objective Cervical spine can be stabilized by different techniques. The hospital stay, operative time, and blood loss were statistically insignificant between the two groups. The screws' size was 3. One of the common techniques used is the lateral mass screws LMSs , which can be inserted either by freehand techniques or three-dimensional 3D navigation system. The use of either a preoperative CT scan or an intraoperative 3D fluoroscopy-based navigation has the advantage of outlining the bony landmarks compared with the MRI. Polyaxial screws have enabled angulated trajectories for placing longer screws toward the superior-lateral-ventral corner of the lateral mass. Surgical indications were cervical myelopathy and fractures. Copyright notice This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives License, which permits unrestricted reproduction and distribution, for non-commercial purposes only; and use and reproduction, but not distribution, of adapted material for non-commercial purposes only, provided the original work is properly cited. The purpose of this study is to evaluate the difference between the 3D navigation system and the freehand technique for cervical spine LMS placement in terms of complications. The exclusion criteria were patients who had previous cervical instrumentation or patients who had 4 mm diameter LMS. Checking the accuracy of the navigation at each level before instrumentation is an important indicator for possible reregistration. A total of subaxial cervical LMS were inserted in 40 consecutive patients. The posterior elements of each. In , Ching 7 used a modified Magerl's technique and reported good results and low complication rate. Including intraoperative complications vertebral artery injury [VAI], nerve root injury [NRI], spinal cord injury [SCI], lateral mass fracture [LMF] and postoperative complications screw malposition, screw complications.
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