Evaluation of 2D and 3D navigation for iliosacral screw fixation

Abstract

3D image guidance for transiliosacral screw fixation enabled more accurate screw placement in S1 and S2 vertebrae. However, radiation exposure in 3D-navigation was excessive; thus, we recommend avoiding 3D-navigation in young patients. A primary advantage of 3D-navigation was that the operating team could leave the room during the scan; thus, it reduced their radiation exposure. Moreover, the time required for screw insertion with 3D-navigation was similar to that required in the conventional technique; thus, 3D-navigation is recommended for older patients.

Comparison of 3D C-arm fluoroscopy and 3D image-guided navigation for minimally invasive pelvic surgery

“…All the differences mentioned above were statistically significant. However, previous studies [25,26] found longer fluoroscopy times and higher radiation dosage when using the 3D navigational system, which differed from our experience. This difference might be explained by our study used only a single C-arm machine in the conventional group.…”

Minimal Invasive Surgical Treatment of Fragility Fractures of the Pelvis

“…In non-dysmorphic sacra, the direction of the iliosacral screw can be transverse (in the coronal plane) and horizontal (35 (38). Accuracy is the highest when using 2D-or 3D-image based navigation, but this procedure needs the availability of an expensive navigation system in the operation theatre (39,40).…”

CT-3D-Fluoroscopy Matching Navigation Can Reduce the Malposition Rate of Iliosacral Screw Insertion for Less-Experienced Surgeons

“…However, screw malposition rates with fluoroscopic guidance have been reported to range from 2% to 68%, [4][5][6][7] with an incidence of neurologic injury between 0.5% and 7.9%. 4,7 To achieve proper screw fixation, various types of computer-assisted techniques, including 2-dimensional (2D) fluoroscopic navigation, 8,9 computed tomography (CT)-based navigation, 10 and 3D fluoroscopic navigation systems have been developed. 5,6,9 A clinical study reported significantly reduced perforation rates and radiation exposure with 3D fluoroscopic navigation compared with conventional technique, although the perforation rate was as high as 31% in the navigated group.…”