Marc Prod'homme, Maxime Saad, Jérôme Tonetti, Guillaume Cavalié, Gaël Kerschbaumer, Arun Thangavelu, Jean-Loup Gassend, Mehdi Boudissa
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The accuracy of the screw positioning was assessed using the Heary and Gertzbein classifications. The effective dose in millisievert (mSv) was calculated.</p><p><strong>Results: </strong>One hundred patients were included, 50 per group. Five hundred and twelve screws were inserted, among them 228 in 120 vertebrae with the O-am and 284 in 145 vertebrae with the SD. Screw accuracy was 99.1% with the O-arm vs 93.3% with the SD (<i>P</i> = 0.07). Operative times were similar, with 145 vs 139 minutes respectively, <i>P</i> = 0.68. The effective dose was significantly higher in the O-arm group, with 5.43 vs 2.70 mSv with the SD (<i>P</i> < 0.01). The effective dose related to 2-dimensional imaging was significantly lower in the O-arm group than in the SD group, with 0.26 vs 1.16 mSv, respectively, <i>P</i> < 0.01, related to a shorter imaging duration (4 vs 109 seconds respectively, <i>P</i> < 0.01).</p><p><strong>Conclusions: </strong>Accuracy of pedicle screws was higher with the O-arm than with the Surgivisio, but the latter showed less radiation exposure. Despite promising results, improvements in technology should be pursued for ergonomics and surgical safety.</p><p><strong>Level of evidence: 4: </strong></p>","PeriodicalId":38486,"journal":{"name":"International Journal of Spine Surgery","volume":" ","pages":""},"PeriodicalIF":1.7000,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"O-Arm Vs Surgivisio for Pedicle Screw Insertion: A Prospective Study on Screw Accuracy and Irradiation on 100 Patients.\",\"authors\":\"Marc Prod'homme, Maxime Saad, Jérôme Tonetti, Guillaume Cavalié, Gaël Kerschbaumer, Arun Thangavelu, Jean-Loup Gassend, Mehdi Boudissa\",\"doi\":\"10.14444/8766\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Computerized navigation improves the accuracy of spine procedures. However, intraoperative imaging is plagued by ionizing irradiation and its cancer risk. 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Operative times were similar, with 145 vs 139 minutes respectively, <i>P</i> = 0.68. The effective dose was significantly higher in the O-arm group, with 5.43 vs 2.70 mSv with the SD (<i>P</i> < 0.01). The effective dose related to 2-dimensional imaging was significantly lower in the O-arm group than in the SD group, with 0.26 vs 1.16 mSv, respectively, <i>P</i> < 0.01, related to a shorter imaging duration (4 vs 109 seconds respectively, <i>P</i> < 0.01).</p><p><strong>Conclusions: </strong>Accuracy of pedicle screws was higher with the O-arm than with the Surgivisio, but the latter showed less radiation exposure. 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引用次数: 0
摘要
背景：计算机导航提高了脊柱手术的准确性。然而，术中成像受到电离辐射及其致癌风险的困扰。先进的技术试图优化辐射剂量。本研究的目的是比较o型臂导航和Surgivisio装置（SD）在椎弓根螺钉置入中的辐射暴露和螺钉精度。方法：在19个月的时间内，所有采用导航椎弓根螺钉置入手术的患者前瞻性地纳入2个脊柱中心：第一个是o型臂，第二个是SD。收集了人口学、手术和辐照数据。使用Heary和Gertzbein分类评估螺钉定位的准确性。计算了有效剂量，单位为毫西弗。结果：纳入100例患者，每组50例。共置入512枚螺钉，其中O-am椎体置入120枚228枚，SD椎体置入145枚284枚。o型臂的螺钉精度为99.1%，SD为93.3% （P = 0.07）。手术时间相似，分别为145和139分钟，P = 0.68。0组有效剂量为5.43 vs2.70 mSv （P < 0.01）。与二维成像相关的有效剂量，o组明显低于SD组，分别为0.26 vs 1.16 mSv, P < 0.01，与成像时间较短相关（4 vs 109 s, P < 0.01）。结论：o型臂固定椎弓根螺钉的准确性高于Surgivisio，但后者的辐射暴露较少。尽管有很好的结果，技术的改进应该追求人体工程学和手术安全。证据等级：4；
O-Arm Vs Surgivisio for Pedicle Screw Insertion: A Prospective Study on Screw Accuracy and Irradiation on 100 Patients.
Background: Computerized navigation improves the accuracy of spine procedures. However, intraoperative imaging is plagued by ionizing irradiation and its cancer risk. Advanced technologies attempt to optimize the radiation dose. The goal of this study was to compare radiation exposure and screw accuracy of O-arm navigation and the Surgivisio device (SD) in pedicle screw insertion.
Methods: All patients operated on by navigated pedicle screw insertion during a 19-month period were prospectively included in 2 spine centers: the first with the O-arm and the second with the SD. Demographic, operative, and irradiation data were collected. The accuracy of the screw positioning was assessed using the Heary and Gertzbein classifications. The effective dose in millisievert (mSv) was calculated.
Results: One hundred patients were included, 50 per group. Five hundred and twelve screws were inserted, among them 228 in 120 vertebrae with the O-am and 284 in 145 vertebrae with the SD. Screw accuracy was 99.1% with the O-arm vs 93.3% with the SD (P = 0.07). Operative times were similar, with 145 vs 139 minutes respectively, P = 0.68. The effective dose was significantly higher in the O-arm group, with 5.43 vs 2.70 mSv with the SD (P < 0.01). The effective dose related to 2-dimensional imaging was significantly lower in the O-arm group than in the SD group, with 0.26 vs 1.16 mSv, respectively, P < 0.01, related to a shorter imaging duration (4 vs 109 seconds respectively, P < 0.01).
Conclusions: Accuracy of pedicle screws was higher with the O-arm than with the Surgivisio, but the latter showed less radiation exposure. Despite promising results, improvements in technology should be pursued for ergonomics and surgical safety.
期刊介绍：
The International Journal of Spine Surgery is the official scientific journal of ISASS, the International Intradiscal Therapy Society, the Pittsburgh Spine Summit, and the Büttner-Janz Spinefoundation, and is an official partner of the Southern Neurosurgical Society. The goal of the International Journal of Spine Surgery is to promote and disseminate online the most up-to-date scientific and clinical research into innovations in motion preservation and new spinal surgery technology, including basic science, biologics, and tissue engineering. The Journal is dedicated to educating spine surgeons worldwide by reporting on the scientific basis, indications, surgical techniques, complications, outcomes, and follow-up data for promising spinal procedures.
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