{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,3]],"date-time":"2026-07-03T19:23:36Z","timestamp":1783106616018,"version":"3.54.6"},"reference-count":62,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"2","license":[{"start":{"date-parts":[[2025,10,17]],"date-time":"2025-10-17T00:00:00Z","timestamp":1760659200000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,10,17]]},"abstract":"<jats:sec>\n                    <jats:title>OBJECTIVE<\/jats:title>\n                    <jats:p>Pedicle screw placement in the cervical spine is a very demanding technique that may lead to critical complications due to the surrounding neurovascular structures. The aim of this investigator-initiated study was to test whether radiation-free, MRI-based, synthetic CT (sCT)\u2013guided spinal navigation is noninferior to CT-guided spinal navigation in terms of safety and accuracy of cervical pedicle screw placement in a cadaveric model.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>The cervical spines of 5 cadavers were scanned with both thin-slice CT and the sCT-MRI sequence. From MRI, sCT scans were artificial intelligence\u2013generated with a previously validated model. Preoperatively, screw trajectories were planned on both CT and sCT. Four spine surgeons performed surface matching and navigated Kirschner wire placement from levels C2 to T2 bilaterally. Randomization (1:1 ratio) was performed for modality, surgeon, and side. Postoperative CT scans were acquired and virtual screws with predefined sizes were projected on the wires. Distance and angulation between intra- and postoperative virtual screw positions were analyzed. Medial and lateral breaches were assessed by an independent researcher using the Gertzbein-Robbins classification, with grades A and B considered satisfactory (&lt; 2 mm).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>Eighty virtual screws were planned. Surface matching was successful in 75 virtual screws (94%). For planning with both modalities, the mean (SD) distance between planned screw trajectories was 1.3 (SD 0.9) mm and 9.2\u00b0 (SD 4.7\u00b0) for the maximum angulation. The mean distance between intra- and postoperative virtual screw positions was 2.2 (SD 1.4) mm for CT and 2.3 (SD 1.9) mm for sCT (p &gt; 0.05). The mean angulation was 4.6\u00b0 (SD 2.5\u00b0) for CT and 5.4\u00b0 (SD 2.9\u00b0) for sCT (p &gt; 0.05). Of the CT-guided virtual screws, 84% were grade A, 13% grade B, and 3% grade C. Of the sCT-navigated virtual screws, 86% were grade A and 14% grade B.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS<\/jats:title>\n                    <jats:p>A complete radiation-free cervical pedicle screw navigation using MRI-based synthetic CT scans in a cadaveric experiment is feasible and as safe and accurate as conventional CT\u2013guided navigation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3171\/2025.6.spine25213","type":"journal-article","created":{"date-parts":[[2025,11,17]],"date-time":"2025-11-17T20:52:08Z","timestamp":1763412728000},"page":"235-241","source":"Crossref","is-referenced-by-count":3,"title":["Safety and accuracy of cervical pedicle screw navigation using artificial intelligence\u2013generated, MRI-based synthetic CT versus conventional CT"],"prefix":"10.3171","volume":"44","author":[{"given":"Peter P. G.","family":"Lafranca","sequence":"first","affiliation":[{"name":"Department of Orthopedic Surgery, UMC Utrecht, The Netherlands;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yorck","family":"Rommelspacher","sequence":"additional","affiliation":[{"name":"Department of Spine Surgery, Krankenhaus der Augustinerinnen, Cologne, North Rhine-Westphalia, Germany;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sander","family":"Muijs","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, UMC Utrecht, The Netherlands;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sebastian G.","family":"Walter","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery and Traumatology, University Hospital Cologne, North Rhine-Westphalia, Germany;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tijl A.","family":"van der Velden","sequence":"additional","affiliation":[{"name":"Department of Radiology, Image Sciences Institute, UMC Utrecht;"},{"name":"MRIguidance B.V., Utrecht; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rene M.","family":"Castelein","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, UMC Utrecht, The Netherlands;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Keita","family":"Ito","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, UMC Utrecht, The Netherlands;"},{"name":"Department of Biomedical Engineering, Eindhoven University of Technology, Eindhoven, Noord-Brabant, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter R.","family":"Seevinck","sequence":"additional","affiliation":[{"name":"Department of Radiology, Image Sciences Institute, UMC Utrecht;"},{"name":"MRIguidance B.V., Utrecht; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tom P. C.","family":"Schl\u00f6sser","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, UMC Utrecht, The Netherlands;"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"issue":"4","key":"b1","series-title":"Tomography","first-page":"614","article-title":"Cervical spine pedicle screw accuracy in fluoroscopic, navigated and template guided systems\u2014a systematic review","volume":"7","author":"Mahmoud A","year":"2021","unstructured":"Mahmoud A, Shanmuganathan K, Rocos B, Sedra F, Montgomery A, Aftab S. Cervical spine pedicle screw accuracy in fluoroscopic, navigated and template guided systems\u2014a systematic review. Tomography. 2021;7(4):614\u2013622."},{"issue":"5","key":"b2","series-title":"J Neurosurg Spine","first-page":"614","article-title":"Screw-related complications in the subaxial cervical spine with the use of lateral mass versus cervical pedicle screws: a systematic review","volume":"19","author":"Yoshihara H","year":"2013","unstructured":"Yoshihara H, Passias PG, Errico TJ. Screw-related complications in the subaxial cervical spine with the use of lateral mass versus cervical pedicle screws: a systematic review. J Neurosurg Spine. 2013;19(5):614\u2013623."},{"issue":"1","key":"b3","series-title":"J Spine Surg","first-page":"252","article-title":"Posterior screw fixation in the subaxial cervical spine: a technique and literature review","volume":"6","author":"Joaquim AF","year":"2020","unstructured":"Joaquim AF, Tan L, Riew KD. Posterior screw fixation in the subaxial cervical spine: a technique and literature review. J Spine Surg. 2020;6(1):252\u2013261."},{"issue":"23","key":"b4","series-title":"J Bone Joint Surg","first-page":"2136","article-title":"Lateral mass screw fixation in the cervical spine","volume":"95","author":"Coe JD","year":"2013","unstructured":"Coe JD, Vaccaro AR, Dailey AT,  Lateral mass screw fixation in the cervical spine. J Bone Joint Surg. 2013;95(23):2136\u20132143."},{"issue":"16","key":"b5","series-title":"Spine (Phila Pa 1976)","first-page":"1853","article-title":"Pedicle screw fixation for nontraumatic lesions of the cervical spine","volume":"22","author":"Abumi K","year":"1997","unstructured":"Abumi K, Kaneda K. Pedicle screw fixation for nontraumatic lesions of the cervical spine. Spine (Phila Pa 1976). 1997;22(16):1853\u20131863."},{"issue":"1","key":"b6","series-title":"Spine (Phila Pa 1976)","first-page":"E16","article-title":"Biomechanical pullout strength and stability of the cervical artificial pedicle screw","volume":"34","author":"Barnes AH","year":"2009","unstructured":"Barnes AH, Eguizabal JA, Acosta FL, Lotz JC, Buckley JM, Ames CP. Biomechanical pullout strength and stability of the cervical artificial pedicle screw. Spine (Phila Pa 1976). 2009;34(1):E16\u2013E20."},{"issue":"11","key":"b7","series-title":"Eur Spine J","first-page":"2729","article-title":"Cervical pedicle screw instrumentation is more reliable with O-arm-based 3D navigation: analysis of cervical pedicle screw placement accuracy with O-arm-based 3D navigation","volume":"27","author":"Chachan S","year":"2018","unstructured":"Chachan S, Bin Abd Razak HR, Loo WL, Allen JC, Shree Kumar D. Cervical pedicle screw instrumentation is more reliable with O-arm-based 3D navigation: analysis of cervical pedicle screw placement accuracy with O-arm-based 3D navigation. Eur Spine J. 2018;27(11):2729\u20132736."},{"issue":"1","key":"b8","series-title":"J Craniovertebr Junction Spine","first-page":"38","article-title":"Intra-operative computer navigation guided cervical pedicle screw insertion in thirty-three complex cervical spine deformities","volume":"1","author":"Rajasekaran S","year":"2010","unstructured":"Rajasekaran S, Kanna PRM, Shetty TAP. Intra-operative computer navigation guided cervical pedicle screw insertion in thirty-three complex cervical spine deformities. J Craniovertebr Junction Spine. 2010;1(1):38\u201343."},{"issue":"2","key":"b9","series-title":"J Neurosurg Spine","first-page":"194","article-title":"The comparative accuracy and safety of fluoroscopic and navigation-based techniques in cervical pedicle screw fixation: systematic review and meta-analysis","volume":"35","author":"Tarawneh AM","year":"2021","unstructured":"Tarawneh AM, Haleem S, D\u2019Aquino D, Quraishi N. The comparative accuracy and safety of fluoroscopic and navigation-based techniques in cervical pedicle screw fixation: systematic review and meta-analysis. J Neurosurg Spine. 2021;35(2):194\u2013201."},{"issue":"2","key":"b10","series-title":"J Neurosurg Spine","first-page":"196","article-title":"The accuracy of pedicle screw placement using intraoperative image guidance systems","volume":"20","author":"Mason A","year":"2014","unstructured":"Mason A, Paulsen R, Babuska JM,  The accuracy of pedicle screw placement using intraoperative image guidance systems. J Neurosurg Spine. 2014;20(2):196\u2013203."},{"issue":"1","key":"b11","series-title":"J Spinal Disord","first-page":"19","article-title":"Transpedicular screw fixation for traumatic lesions of the middle and lower cervical spine: description of the techniques and preliminary report","volume":"7","author":"Abumi K","year":"1994","unstructured":"Abumi K, Itoh H, Taneichi H, Kaneda K. Transpedicular screw fixation for traumatic lesions of the middle and lower cervical spine: description of the techniques and preliminary report. J Spinal Disord. 1994;7(1):19\u201328."},{"issue":"5","key":"b12","series-title":"J Am Acad Orthop Surg Glob Res Rev","first-page":"e22.00031","article-title":"Increased prevalence of breast and all-cause cancer in female orthopaedic surgeons","volume":"6","author":"Chou LB","year":"2022","unstructured":"Chou LB, Johnson B, Shapiro LM,  Increased prevalence of breast and all-cause cancer in female orthopaedic surgeons. J Am Acad Orthop Surg Glob Res Rev. 2022;6(5):e22.00031."},{"issue":"5","key":"b13","series-title":"Womens Health Issues","first-page":"476","article-title":"Cancer prevalence among a cross-sectional survey of female orthopedic, urology, and plastic surgeons in the United States","volume":"25","author":"Chou LB","year":"2015","unstructured":"Chou LB, Lerner LB, Harris AHS, Brandon AJ, Girod S, Butler LM. Cancer prevalence among a cross-sectional survey of female orthopedic, urology, and plastic surgeons in the United States. Womens Health Issues. 2015;25(5):476\u2013481."},{"issue":"6","key":"b14","series-title":"Spine J","first-page":"1087","article-title":"Intraoperative navigation increases the projected lifetime cancer risk in patients undergoing surgery for adolescent idiopathic scoliosis","volume":"24","author":"Striano BM","year":"2024","unstructured":"Striano BM, Crawford AM, Verhofste BP,  Intraoperative navigation increases the projected lifetime cancer risk in patients undergoing surgery for adolescent idiopathic scoliosis. Spine J. 2024;24(6):1087\u20131094."},{"issue":"2","key":"b15","series-title":"Global Spine J","first-page":"1243","article-title":"Robot-assisted lumbar pedicle screw placement based on 3D magnetic resonance imaging","volume":"15","author":"Altorfer FCS","year":"2025","unstructured":"Altorfer FCS, Burkhard MD, Kelly MJ,  Robot-assisted lumbar pedicle screw placement based on 3D magnetic resonance imaging. Global Spine J. 2025;15(2):1243\u20131250."},{"issue":"5","key":"b16","series-title":"Spine J","first-page":"1035","article-title":"Robotic pedicle screw placement with 3D MRI registration: moving towards radiation free robotic spine surgery","volume":"25","author":"Altorfer FCS","year":"2024","unstructured":"Altorfer FCS, Kelly MJ, Avrumova F,  Robotic pedicle screw placement with 3D MRI registration: moving towards radiation free robotic spine surgery. Spine J. 2024;25(5):1035\u20131041."},{"issue":"11","key":"b17","series-title":"Eur Spine J","first-page":"4144","article-title":"Deep-learning reconstructed lumbar spine 3D MRI for surgical planning: pedicle screw placement and geometric measurements compared to CT","volume":"33","author":"Abel F","year":"2024","unstructured":"Abel F, Lebl DR, Gorgy G,  Deep-learning reconstructed lumbar spine 3D MRI for surgical planning: pedicle screw placement and geometric measurements compared to CT. Eur Spine J. 2024;33(11):4144\u20134154."},{"issue":"4","key":"b18","series-title":"J Orthop Res","first-page":"954","article-title":"MRI-based synthetic CT shows equivalence to conventional CT for the morphological assessment of the hip joint","volume":"40","author":"Florkow MC","year":"2022","unstructured":"Florkow MC, Willemsen K, Zijlstra F,  MRI-based synthetic CT shows equivalence to conventional CT for the morphological assessment of the hip joint. J Orthop Res. 2022;40(4):954\u2013964."},{"issue":"2","key":"b19","series-title":"Radiology","first-page":"343","article-title":"MRI-based synthetic CT in the detection of structural lesions in patients with suspected sacroiliitis: comparison with MRI","volume":"298","author":"Jans LBO","year":"2021","unstructured":"Jans LBO, Chen M, Elewaut D,  MRI-based synthetic CT in the detection of structural lesions in patients with suspected sacroiliitis: comparison with MRI. Radiology. 2021;298(2):343\u2013349."},{"key":"b20","series-title":"Eur J Radiol","first-page":"109999","article-title":"MRI-based synthetic CT of the lumbar spine: geometric measurements for surgery planning in comparison with CT","volume":"144","author":"Morb\u00e9e L","year":"2021","unstructured":"Morb\u00e9e L, Chen M, Herregods N, Pullens P, Jans LBO. MRI-based synthetic CT of the lumbar spine: geometric measurements for surgery planning in comparison with CT. Eur J Radiol. 2021;144:109999."},{"key":"b21","series-title":"Eur J Radiol","first-page":"110414","article-title":"Bone visualization of the cervical spine with deep learning-based synthetic CT compared to conventional CT: a single-center noninferiority study on image quality","volume":"154","author":"van der Kolk BBYM","year":"2022","unstructured":"van der Kolk BBYM, Slotman DJJ, Nijholt IM,  Bone visualization of the cervical spine with deep learning-based synthetic CT compared to conventional CT: a single-center noninferiority study on image quality. Eur J Radiol. 2022;154:110414."},{"issue":"2","key":"b22","series-title":"Illustrative case. J Neurosurg Case Lessons","first-page":"CASE23120","article-title":"Robot-assisted screw fixation in a cadaver utilizing magnetic resonance imaging\u2013based synthetic computed tomography: toward radiation-free spine surgery","volume":"6","author":"Davidar AD","year":"2023","unstructured":"Davidar AD, Judy BF, Hersh AM,  Robot-assisted screw fixation in a cadaver utilizing magnetic resonance imaging\u2013based synthetic computed tomography: toward radiation-free spine surgery. Illustrative case. J Neurosurg Case Lessons. 2023;6(2):CASE23120."},{"issue":"1","key":"b23","series-title":"Spine (Phila Pa 1976)","first-page":"11","article-title":"Accuracy of pedicular screw placement in vivo","volume":"15","author":"Gertzbein SD","year":"1990","unstructured":"Gertzbein SD, Robbins SE. Accuracy of pedicular screw placement in vivo. Spine (Phila Pa 1976). 1990;15(1):11\u201314."},{"issue":"10","key":"b24","series-title":"Eur Spine J","first-page":"3366","article-title":"Incidence of cancer in adolescent idiopathic scoliosis patients treated 25 years previously","volume":"25","author":"Simony A","year":"2016","unstructured":"Simony A, Hansen EJ, Christensen SB, Carreon LY, Andersen MO. Incidence of cancer in adolescent idiopathic scoliosis patients treated 25 years previously. Eur Spine J. 2016;25(10):3366\u20133370."},{"key":"b25","series-title":"World Neurosurg","first-page":"e182","article-title":"Cervical pedicle screw insertion using O-arm-based 3D navigation: technical advancement to improve accuracy of screws","volume":"139","author":"Wada K","year":"2020","unstructured":"Wada K, Tamaki R, Inoue T, Hagiwara K, Okazaki K. Cervical pedicle screw insertion using O-arm-based 3D navigation: technical advancement to improve accuracy of screws. World Neurosurg. 2020;139:e182\u2013e188."},{"issue":"2","key":"b26","series-title":"Neurosurg Rev","first-page":"251","article-title":"Surgical safety of cervical pedicle screw placement with computer navigation system","volume":"40","author":"Shimokawa N","year":"2017","unstructured":"Shimokawa N, Takami T. Surgical safety of cervical pedicle screw placement with computer navigation system. Neurosurg Rev. 2017;40(2):251\u2013258."},{"issue":"3","key":"b27","series-title":"Global Spine J","first-page":"1018","article-title":"Accurate placement and revisions for cervical pedicle screws placed with or without navigation: a systematic review and meta-analysis","volume":"14","author":"Bindels BJJ","year":"2024","unstructured":"Bindels BJJ, Dronkers BEG, Smits MLJ, Verlaan JJ. Accurate placement and revisions for cervical pedicle screws placed with or without navigation: a systematic review and meta-analysis. Global Spine J. 2024;14(3):1018\u20131037."},{"issue":"7","key":"b28","series-title":"Int Orthop","first-page":"1903","article-title":"Accuracy and clinical characteristics of robot-assisted cervical spine surgery: a systematic review and meta-analysis","volume":"48","author":"Wu J","year":"2024","unstructured":"Wu J, Fan M, He D,  Accuracy and clinical characteristics of robot-assisted cervical spine surgery: a systematic review and meta-analysis. Int Orthop. 2024;48(7):1903\u20131914."},{"issue":"1","key":"b29","series-title":"Sci Rep","first-page":"10881","article-title":"Feasibility and safety report on robotic assistance for cervical pedicle screw fixation: a cadaveric study","volume":"14","author":"Ryu S","year":"2024","unstructured":"Ryu S, Ha BJ, Yoon S,  Feasibility and safety report on robotic assistance for cervical pedicle screw fixation: a cadaveric study. Sci Rep. 2024;14(1):10881."},{"issue":"1","key":"b30","series-title":"Eur Spine J","first-page":"105","article-title":"Robotic assistance for upper cervical instrumentation: report on accuracy and safety","volume":"34","author":"Luo K","year":"2025","unstructured":"Luo K, Zou X, Chen W,  Robotic assistance for upper cervical instrumentation: report on accuracy and safety. Eur Spine J. 2025;34(1):105\u2013117."},{"issue":"7","key":"b31","series-title":"Orthop Surg","first-page":"1823","article-title":"Operative effect comparison of flexible drill guiding vs. traditional drill guiding template for lower cervical pedicle screw insertion: a retrospective analysis","volume":"15","author":"Wu C","year":"2023","unstructured":"Wu C, Deng J, Hu H,  Operative effect comparison of flexible drill guiding vs. traditional drill guiding template for lower cervical pedicle screw insertion: a retrospective analysis. Orthop Surg. 2023;15(7):1823\u20131830."},{"issue":"4","key":"b1","series-title":"Tomography","first-page":"614","article-title":"Cervical spine pedicle screw accuracy in fluoroscopic, navigated and template guided systems\u2014a systematic review","volume":"7","author":"Mahmoud A","year":"2021","unstructured":"Mahmoud A, Shanmuganathan K, Rocos B, Sedra F, Montgomery A, Aftab S. Cervical spine pedicle screw accuracy in fluoroscopic, navigated and template guided systems\u2014a systematic review. Tomography. 2021;7(4):614\u2013622."},{"issue":"5","key":"b2","series-title":"J Neurosurg Spine","first-page":"614","article-title":"Screw-related complications in the subaxial cervical spine with the use of lateral mass versus cervical pedicle screws: a systematic review","volume":"19","author":"Yoshihara H","year":"2013","unstructured":"Yoshihara H, Passias PG, Errico TJ. Screw-related complications in the subaxial cervical spine with the use of lateral mass versus cervical pedicle screws: a systematic review. J Neurosurg Spine. 2013;19(5):614\u2013623."},{"issue":"1","key":"b3","series-title":"J Spine Surg","first-page":"252","article-title":"Posterior screw fixation in the subaxial cervical spine: a technique and literature review","volume":"6","author":"Joaquim AF","year":"2020","unstructured":"Joaquim AF, Tan L, Riew KD. Posterior screw fixation in the subaxial cervical spine: a technique and literature review. J Spine Surg. 2020;6(1):252\u2013261."},{"issue":"23","key":"b4","series-title":"J Bone Joint Surg","first-page":"2136","article-title":"Lateral mass screw fixation in the cervical spine","volume":"95","author":"Coe JD","year":"2013","unstructured":"Coe JD, Vaccaro AR, Dailey AT,  Lateral mass screw fixation in the cervical spine. J Bone Joint Surg. 2013;95(23):2136\u20132143."},{"issue":"16","key":"b5","series-title":"Spine (Phila Pa 1976)","first-page":"1853","article-title":"Pedicle screw fixation for nontraumatic lesions of the cervical spine","volume":"22","author":"Abumi K","year":"1997","unstructured":"Abumi K, Kaneda K. Pedicle screw fixation for nontraumatic lesions of the cervical spine. Spine (Phila Pa 1976). 1997;22(16):1853\u20131863."},{"issue":"1","key":"b6","series-title":"Spine (Phila Pa 1976)","first-page":"E16","article-title":"Biomechanical pullout strength and stability of the cervical artificial pedicle screw","volume":"34","author":"Barnes AH","year":"2009","unstructured":"Barnes AH, Eguizabal JA, Acosta FL, Lotz JC, Buckley JM, Ames CP. Biomechanical pullout strength and stability of the cervical artificial pedicle screw. Spine (Phila Pa 1976). 2009;34(1):E16\u2013E20."},{"issue":"11","key":"b7","series-title":"Eur Spine J","first-page":"2729","article-title":"Cervical pedicle screw instrumentation is more reliable with O-arm-based 3D navigation: analysis of cervical pedicle screw placement accuracy with O-arm-based 3D navigation","volume":"27","author":"Chachan S","year":"2018","unstructured":"Chachan S, Bin Abd Razak HR, Loo WL, Allen JC, Shree Kumar D. Cervical pedicle screw instrumentation is more reliable with O-arm-based 3D navigation: analysis of cervical pedicle screw placement accuracy with O-arm-based 3D navigation. Eur Spine J. 2018;27(11):2729\u20132736."},{"issue":"1","key":"b8","series-title":"J Craniovertebr Junction Spine","first-page":"38","article-title":"Intra-operative computer navigation guided cervical pedicle screw insertion in thirty-three complex cervical spine deformities","volume":"1","author":"Rajasekaran S","year":"2010","unstructured":"Rajasekaran S, Kanna PRM, Shetty TAP. Intra-operative computer navigation guided cervical pedicle screw insertion in thirty-three complex cervical spine deformities. J Craniovertebr Junction Spine. 2010;1(1):38\u201343."},{"issue":"2","key":"b9","series-title":"J Neurosurg Spine","first-page":"194","article-title":"The comparative accuracy and safety of fluoroscopic and navigation-based techniques in cervical pedicle screw fixation: systematic review and meta-analysis","volume":"35","author":"Tarawneh AM","year":"2021","unstructured":"Tarawneh AM, Haleem S, D\u2019Aquino D, Quraishi N. The comparative accuracy and safety of fluoroscopic and navigation-based techniques in cervical pedicle screw fixation: systematic review and meta-analysis. J Neurosurg Spine. 2021;35(2):194\u2013201."},{"issue":"2","key":"b10","series-title":"J Neurosurg Spine","first-page":"196","article-title":"The accuracy of pedicle screw placement using intraoperative image guidance systems","volume":"20","author":"Mason A","year":"2014","unstructured":"Mason A, Paulsen R, Babuska JM,  The accuracy of pedicle screw placement using intraoperative image guidance systems. J Neurosurg Spine. 2014;20(2):196\u2013203."},{"issue":"1","key":"b11","series-title":"J Spinal Disord","first-page":"19","article-title":"Transpedicular screw fixation for traumatic lesions of the middle and lower cervical spine: description of the techniques and preliminary report","volume":"7","author":"Abumi K","year":"1994","unstructured":"Abumi K, Itoh H, Taneichi H, Kaneda K. Transpedicular screw fixation for traumatic lesions of the middle and lower cervical spine: description of the techniques and preliminary report. J Spinal Disord. 1994;7(1):19\u201328."},{"issue":"5","key":"b12","series-title":"J Am Acad Orthop Surg Glob Res Rev","first-page":"e22.00031","article-title":"Increased prevalence of breast and all-cause cancer in female orthopaedic surgeons","volume":"6","author":"Chou LB","year":"2022","unstructured":"Chou LB, Johnson B, Shapiro LM,  Increased prevalence of breast and all-cause cancer in female orthopaedic surgeons. J Am Acad Orthop Surg Glob Res Rev. 2022;6(5):e22.00031."},{"issue":"5","key":"b13","series-title":"Womens Health Issues","first-page":"476","article-title":"Cancer prevalence among a cross-sectional survey of female orthopedic, urology, and plastic surgeons in the United States","volume":"25","author":"Chou LB","year":"2015","unstructured":"Chou LB, Lerner LB, Harris AHS, Brandon AJ, Girod S, Butler LM. Cancer prevalence among a cross-sectional survey of female orthopedic, urology, and plastic surgeons in the United States. Womens Health Issues. 2015;25(5):476\u2013481."},{"issue":"6","key":"b14","series-title":"Spine J","first-page":"1087","article-title":"Intraoperative navigation increases the projected lifetime cancer risk in patients undergoing surgery for adolescent idiopathic scoliosis","volume":"24","author":"Striano BM","year":"2024","unstructured":"Striano BM, Crawford AM, Verhofste BP,  Intraoperative navigation increases the projected lifetime cancer risk in patients undergoing surgery for adolescent idiopathic scoliosis. Spine J. 2024;24(6):1087\u20131094."},{"issue":"2","key":"b15","series-title":"Global Spine J","first-page":"1243","article-title":"Robot-assisted lumbar pedicle screw placement based on 3D magnetic resonance imaging","volume":"15","author":"Altorfer FCS","year":"2025","unstructured":"Altorfer FCS, Burkhard MD, Kelly MJ,  Robot-assisted lumbar pedicle screw placement based on 3D magnetic resonance imaging. 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