Comparison of surgical outcomes of C1-2 fusion surgery between O-arm-assisted operation and C-arm assisted operation in children with atlantoaxial rotatory fixation

ObjectivePlacement of the pedicle screw is technically challenging during C1-2 fusion surgery in children and different intraoperative image-guided systems have been developed to reduce the risk of screw malposition. The purpose of the present study was to compare surgical outcomes between C-arm flu...

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Main Authors: Xin Zhou, Yue Benny Yang, Yichen Meng, Tao Lin, Xuhui Zhou, Ce Wang
Format: Article
Language:English
Published: Frontiers Media S.A. 2023-02-01
Series:Frontiers in Pediatrics
Subjects:
Online Access:https://www.frontiersin.org/articles/10.3389/fped.2023.1059844/full
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author Xin Zhou
Yue Benny Yang
Yichen Meng
Yichen Meng
Yichen Meng
Tao Lin
Xuhui Zhou
Ce Wang
author_facet Xin Zhou
Yue Benny Yang
Yichen Meng
Yichen Meng
Yichen Meng
Tao Lin
Xuhui Zhou
Ce Wang
author_sort Xin Zhou
collection DOAJ
description ObjectivePlacement of the pedicle screw is technically challenging during C1-2 fusion surgery in children and different intraoperative image-guided systems have been developed to reduce the risk of screw malposition. The purpose of the present study was to compare surgical outcomes between C-arm fluoroscopy and O-arm navigated pedicle screw placement in the treatment of atlantoaxial rotatory fixation in children.MethodsWe retrospectively evaluated charts of all consecutive children with atlantoaxial rotatory fixation who underwent C-arm fluoroscopy or O-arm navigated pedicle screw placement from April 2014 to December 2020. Outcomes including operative time, estimated blood loss (EBL), accuracy of screw placement (Neo's classification) and completed fusion time were evaluated.ResultsA total of 340 screws were placed in 85 patients. The accuracy of screw placement of the O-arm group was 97.4%, which was significantly higher than that of the C-arm group (91.8%). Both groups had satisfied bony fusion (100%). Statistical significance (230.0 ± 34.6 ml for the C-arm group and 150.6 ± 47.3 ml for the O-arm group, p < 0.05) was observed with respect to the median blood loss. There were no statistically significant difference (122.0 ± 16.5 min for the C-arm group and 110.0 ± 14.4 min for the O-arm group, p = 0.604) with respect to the median operative time.ConclusionO-arm-assisted navigation allowed more accurate screw placement and less intraoperative blood loss. Both groups had satisfied bony fusion. O-arm navigation did not prolong the operative time despite the time required for setting and scanning.
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spelling doaj.art-2cc9cefb601446f0a818ff109aebc4b22023-02-20T06:01:34ZengFrontiers Media S.A.Frontiers in Pediatrics2296-23602023-02-011110.3389/fped.2023.10598441059844Comparison of surgical outcomes of C1-2 fusion surgery between O-arm-assisted operation and C-arm assisted operation in children with atlantoaxial rotatory fixationXin Zhou0Yue Benny Yang1Yichen Meng2Yichen Meng3Yichen Meng4Tao Lin5Xuhui Zhou6Ce Wang7Department of Orthopedics, Second Affiliated Hospital of Naval Medical University, Shanghai, ChinaDepartment of Orthopedics, Second Affiliated Hospital of Naval Medical University, Shanghai, ChinaDepartment of Orthopedics, Second Affiliated Hospital of Naval Medical University, Shanghai, ChinaDepartment of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, ChinaShanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai Key Laboratory for Endocrine Tumor, State Key Laboratory of Medical Genomics, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, ChinaDepartment of Orthopedics, Second Affiliated Hospital of Naval Medical University, Shanghai, ChinaDepartment of Orthopedics, Second Affiliated Hospital of Naval Medical University, Shanghai, ChinaDepartment of Orthopedics, Second Affiliated Hospital of Naval Medical University, Shanghai, ChinaObjectivePlacement of the pedicle screw is technically challenging during C1-2 fusion surgery in children and different intraoperative image-guided systems have been developed to reduce the risk of screw malposition. The purpose of the present study was to compare surgical outcomes between C-arm fluoroscopy and O-arm navigated pedicle screw placement in the treatment of atlantoaxial rotatory fixation in children.MethodsWe retrospectively evaluated charts of all consecutive children with atlantoaxial rotatory fixation who underwent C-arm fluoroscopy or O-arm navigated pedicle screw placement from April 2014 to December 2020. Outcomes including operative time, estimated blood loss (EBL), accuracy of screw placement (Neo's classification) and completed fusion time were evaluated.ResultsA total of 340 screws were placed in 85 patients. The accuracy of screw placement of the O-arm group was 97.4%, which was significantly higher than that of the C-arm group (91.8%). Both groups had satisfied bony fusion (100%). Statistical significance (230.0 ± 34.6 ml for the C-arm group and 150.6 ± 47.3 ml for the O-arm group, p < 0.05) was observed with respect to the median blood loss. There were no statistically significant difference (122.0 ± 16.5 min for the C-arm group and 110.0 ± 14.4 min for the O-arm group, p = 0.604) with respect to the median operative time.ConclusionO-arm-assisted navigation allowed more accurate screw placement and less intraoperative blood loss. Both groups had satisfied bony fusion. O-arm navigation did not prolong the operative time despite the time required for setting and scanning.https://www.frontiersin.org/articles/10.3389/fped.2023.1059844/fullo-armatlantoaxial rotatory fixationnavigationchildrenpedicle screws
spellingShingle Xin Zhou
Yue Benny Yang
Yichen Meng
Yichen Meng
Yichen Meng
Tao Lin
Xuhui Zhou
Ce Wang
Comparison of surgical outcomes of C1-2 fusion surgery between O-arm-assisted operation and C-arm assisted operation in children with atlantoaxial rotatory fixation
Frontiers in Pediatrics
o-arm
atlantoaxial rotatory fixation
navigation
children
pedicle screws
title Comparison of surgical outcomes of C1-2 fusion surgery between O-arm-assisted operation and C-arm assisted operation in children with atlantoaxial rotatory fixation
title_full Comparison of surgical outcomes of C1-2 fusion surgery between O-arm-assisted operation and C-arm assisted operation in children with atlantoaxial rotatory fixation
title_fullStr Comparison of surgical outcomes of C1-2 fusion surgery between O-arm-assisted operation and C-arm assisted operation in children with atlantoaxial rotatory fixation
title_full_unstemmed Comparison of surgical outcomes of C1-2 fusion surgery between O-arm-assisted operation and C-arm assisted operation in children with atlantoaxial rotatory fixation
title_short Comparison of surgical outcomes of C1-2 fusion surgery between O-arm-assisted operation and C-arm assisted operation in children with atlantoaxial rotatory fixation
title_sort comparison of surgical outcomes of c1 2 fusion surgery between o arm assisted operation and c arm assisted operation in children with atlantoaxial rotatory fixation
topic o-arm
atlantoaxial rotatory fixation
navigation
children
pedicle screws
url https://www.frontiersin.org/articles/10.3389/fped.2023.1059844/full
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