The use of an Intraoperative Computed Tomograph with a Navigation Station for Operations on the Spine

The aim of the study: to analyze the results of using an intraoperative computed tomography scanner with a navigation station during spinal operations. Methods. The authors conducted a retrospective and prospective analysis of the results of 350 operations using the image intensifier tube, 390 operations with O arm and 11 operations with O arm and the Stealth-Station navigation station (Medtronic, USA). To the 350 patients operated on using the image intensifier, 1822 screws were implanted, on average 5.2 screws per operation. 117 (6.5%) screws were implanted incorrectly, of which a permissible or clinically insignificant malposition of the screw was noted in 90 (4.9%) patients. Incorrectly installed screws remaining in 27 (1.5%) patients required revision surgery. To 390 patients operated with O arm, 2477 screws were implanted, on average 6.3 screws during one operation. Incorrectly 33 (1.3%) screws were implanted, of which 25 screws were acceptable malposition. Invalid malposition of 8 (0.3%) screws was eliminated during the current operation. Results. Comparative studies of the total number of incorrectly implanted screws during operations using the image intensifier tube and O arm showed that they were more often observed when using the image intensifier tube (p <0.001) and there was no unacceptable malposition of the screws when performing the operation under O arm, since it was diagnosed in time during current operation and eliminated. A total of 66 screws were implanted in 11 patients operated using O arm and the Stealth-Station navigation station, an average of 6 screws during one operation. Inaccurate implantation of screws was not observed in any patient. Conclusions. O-arm with the Stealth-Station navigation station is the most modern method of controlling the correctness of spinal operations when anatomical landmarks are partially invisible - with open operations or invisible at all - with minimally invasive surgical interventions in real time.