{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,20]],"date-time":"2026-02-20T18:25:45Z","timestamp":1771611945451,"version":"3.50.1"},"reference-count":27,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["SPI"],"published-print":{"date-parts":[[2015,2]]},"abstract":"<jats:sec>\n<jats:title>OBJECT<\/jats:title>\n<jats:p>Fractures of C-1 and C-2 are complex and surgical management may be difficult and challenging due to the anatomical relationship sbetween the vertebrae and neurovascular structures. The aim of this study was to evaluate the role, reliability, and accuracy of cervical fixation using the O-arm intraoperative 3D image\u2013based navigation system.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>METHODS<\/jats:title>\n<jats:p>The authors evaluated patients who underwent a navigation system\u2013based surgery for stabilization of a fracture of C-1 and\/or C-2 from August 2011 to August 2013. All of the fixation screws were intraoperatively checked and their position was graded.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>RESULTS<\/jats:title>\n<jats:p>The patient population comprised 17 patients whose median age was 47.6 years. The surgical procedures were as follows: anterior dens screw fixation in 2 cases, transarticular fixation of C-1 and C-2 in 1 case, fixation using the Harms technique in 12 cases, and occipitocervical fixation in 2 cases. A total of 67 screws were placed. The control intraoperative CT scan revealed 62 screws (92.6%) correctly placed, 4 (5.9%) with a minor cortical violation (&lt; 2 mm), and only 1 screw (1.5%) that was judged to be incorrectly placed and that was immediately corrected. No vascular injury of the vertebral artery was observed either during exposition or during screw placement. No implant failure was observed.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>CONCLUSIONS<\/jats:title>\n<jats:p>The use of a navigation system based on an intraoperative CT allows a real-time visualization of the vertebrae, reducing the risks of screw misplacement and consequent complications.<\/jats:p><\/jats:sec>","DOI":"10.3171\/2014.10.spine14122","type":"journal-article","created":{"date-parts":[[2014,11,21]],"date-time":"2014-11-21T15:09:51Z","timestamp":1416582591000},"page":"128-133","source":"Crossref","is-referenced-by-count":29,"title":["Management of C1\u20132 traumatic fractures using an intraoperative 3D imaging\u2013based navigation system"],"prefix":"10.3171","volume":"22","author":[{"given":"Francesco","family":"Costa","sequence":"first","affiliation":[{"name":"Departments of Neurosurgery and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alessandro","family":"Ortolina","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Luca","family":"Attuati","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrea","family":"Cardia","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Massimo","family":"Tomei","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marco","family":"Riva","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Luca","family":"Balzarini","sequence":"additional","affiliation":[{"name":"Radiology, Humanitas Clinical and Research Center, Rozzano, Milan, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maurizio","family":"Fornari","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery and"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1754","reference":[{"key":"b1-spine14122","series-title":"Neurol India","doi-asserted-by":"publisher","first-page":"590","DOI":"10.4103\/0028-3886.84343","article-title":"Use of O-arm for spinal surgery in academic institution in India: experience from JPN apex trauma centre","volume":"59","author":"Ailawadhi","year":"2011"},{"key":"b2-spine14122","series-title":"J Bone Joint Surg Am","doi-asserted-by":"publisher","first-page":"1663","DOI":"10.2106\/00004623-197456080-00017","article-title":"Fractures of the odontoid process of the axis","volume":"56","author":"Anderson","year":"1974"},{"key":"b3-spine14122","series-title":"Spine (Phila Pa 1976)","doi-asserted-by":"publisher","first-page":"1208","DOI":"10.1097\/00007632-199505150-00019","article-title":"Computer-assisted pedicle screw fixation. 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