Surgical outcomes of intraoperative O-arm versus C-arm fluoroscopy in occipitocervical fixation: a retrospective analysis.

IF 1 4区医学 Q4 CLINICAL NEUROLOGY

British Journal of Neurosurgery Pub Date : 2025-06-01 Epub Date: 2023-12-25 DOI:10.1080/02688697.2023.2297879

Keiji Wada, Shunichi Mori, Shuji Shimamoto, Tomohisa Inoue, Ryo Tamaki, Ken Okazaki

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引用次数: 0

Abstract

Purpose: This study aims to compare the effect of using O-arm and C-arm fluoroscopy on the surgical outcomes of occipitocervical fixation.

Methods: The study included patients who underwent occipitocervical fixation using O-arm or C-arm between 2005 and 2021. Of 56 patients, 34 underwent O-arm-assisted surgery (O-group) and 22 underwent C-arm-assisted surgery (C-group). We assessed surgical outcomes, including operative time, intraoperative blood loss, perioperative complications, and bone union.

Results: Almost half of the patients had rheumatoid arthritis-related disorders in both groups. Sixteen cases (47.1%) in the O-group and 12 cases (54.5%) in the C-group were fixed from occipito (Oc) to C3, 12 cases (38.2%) in the O-group and 7 cases (31.8%) in the C-group from Oc to C4-7, 5 cases (14.7%) in the O-group, and 3 cases (13.6%) in the C-group from Oc to T2 (p = 0.929). There was no significant difference in operative time (p = 0.239) and intraoperative blood loss (p = 0.595) between the two groups. Dysphagia was the most common complication in both groups (O-group vs. C-group, 11.7% vs. 9.1%). Regarding implant-related complications, occipital plate dislodgement was observed in four cases (18.2%) in the C-group (p = 0.02). The bone union rate was 96.3% in the O-group and 93.3% in the C-group (P = 1).

Conclusions: O-arm use is associated with a reduced rate of occipital plate dislodgment and has a similar complication incidence compared with C-arm-assisted surgery and does not prolong operative time despite the time needed for setting and scanning. Accordingly, an O-arm is safe and useful for occipitocervical fixation surgery.

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枕骨颈固定术中 O 型臂透视与 C 型臂透视的手术效果：回顾性分析。

目的：本研究旨在比较使用O型臂和C型臂透视对枕颈固定术手术效果的影响：研究纳入了2005年至2021年间使用O型臂或C型臂进行枕颈固定术的患者。在56名患者中，34人接受了O型臂辅助手术（O组），22人接受了C型臂辅助手术（C组）。我们对手术结果进行了评估，包括手术时间、术中失血量、围手术期并发症和骨结合情况：结果：两组患者中几乎有一半患有类风湿性关节炎相关疾病。O组16例（47.1%）和C组12例（54.5%）从枕骨（Oc）至C3固定，O组12例（38.2%）和C组7例（31.8%）从Oc至C4-7固定，O组5例（14.7%）和C组3例（13.6%）从Oc至T2固定（P = 0.929）。两组患者的手术时间（p = 0.239）和术中失血量（p = 0.595）无明显差异。吞咽困难是两组最常见的并发症（O 组对 C 组，11.7% 对 9.1%）。在与种植体相关的并发症方面，C 组有四例（18.2%）出现枕骨板脱落（P = 0.02）。O组的骨结合率为96.3%，C组为93.3%（P = 1）：结论：使用 O 型臂可降低枕骨钢板脱落率，并发症发生率与 C 型臂辅助手术相似，尽管需要时间进行设置和扫描，但不会延长手术时间。因此，O 型臂在枕颈固定手术中是安全和有用的。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

British Journal of Neurosurgery 医学-临床神经学

CiteScore

2.30

自引率

9.10%

发文量

139

审稿时长

3-8 weeks

期刊介绍： The British Journal of Neurosurgery is a leading international forum for debate in the field of neurosurgery, publishing original peer-reviewed articles of the highest quality, along with comment and correspondence on all topics of current interest to neurosurgeons worldwide. Coverage includes all aspects of case assessment and surgical practice, as well as wide-ranging research, with an emphasis on clinical rather than experimental material. Special emphasis is placed on postgraduate education with review articles on basic neurosciences and on the theory behind advances in techniques, investigation and clinical management. All papers are submitted to rigorous and independent peer-review, ensuring the journal’s wide citation and its appearance in the major abstracting and indexing services.