Objective: To assess the value of computer navigation technique in spinal pedicle screw insertion.
Methods: 95 patients undergoing spinal pedicle screw internal fixation were randomly divided in 2 groups:navigation group (n=36) undergoing pedicle screw insertion with computer-assisted navigation technique, and conventional group (n=50) undergoing pedicle screw insertion using conventional anatomic landmark combined. The 2 groups were compared in respect to screw canal preparation time, accuracy of screw position, and incidence of postoperative complication.
Results: 206 screws were inserted in the navigation group, 169 being with excellent outcome (82.0%), 29 with good outcome (14.1%), and 8 with bad outcome (3.9%). Nine patients in the navigation group failed to adopt the computer-assisted navigation technique because of different reasons. 285 screws were inserted in the conventional group, 257 being were excellent outcome (90.2%), 28 with good outcome (9.8%), and none with bad outcome. The general fitness rate of the navigation group was 96.1%, not significantly different from that of the conventional group (100%, P>0.05). The screw canal preparation time of the navigation group was (360+/-22) sec, significantly longer than that of the conventional group [(56+/-8) sec, P<0.001)]. No postoperative complication was found in both groups.
Conclusion: The accuracy of pedicle screw insertion using preoperative CT-based navigation technique is not different from that using conventional anatomic landmark, but the operation time is significantly prolonged. Preoperative CT-based navigation technique has limited value in spinal pedicle screw insertion.