Comparison of intraoperative CT-based navigation versus non-navigated pedicle screw placement in surgical correction of spinal deformity

Objective To explore the results and clinical value of intraoperative computed tomography (iCT) navigation in pedicle screw insertion accuracy in comparison to screw placement without navigation in spinal deformity surgery. Methods Clinical data about 100 patients who underwent surgical deformity correction with assistance of iCT in our hospital from 2009 to 2012 were retrospectively analyzed. All patients were divided into two groups:navigation group (n=37), and non-navigation group (n=63). In each group, patients were divided into different subgroups according to the spinal segment (thoracic vertebrae, upper/middle/lower thoracic vertebrae, lumbar vertebrae). The screw placement accuracy was analyzed. Results Compared with non-navigation group, there showed a higher accuracy rate and a lower revision rate of total pedicle screws placement in navigation group (94.61% vs 88.43%, 2.43% vs 6.06%, P< 0.05). The screws insertion accuracy rate of thoracic pedicle screws, middle and lower thoracic screws in navigation group was higher and the revision rate was lower than that of non-navigation group. However, no significant difference was found in upper thoracic and lumbar pedicle screws (P< 0.05). Conclusion The iCT navigation system provides a high accuracy of pedicle screw placement in surgical correction of spinal deformity, especially in thoracic spinal instrumentation.