{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T14:41:34Z","timestamp":1790779294329,"version":"4.1.0"},"reference-count":18,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["SPI"],"published-print":{"date-parts":[[2008,11]]},"abstract":"<jats:sec>\n<jats:title>Object<\/jats:title>\n<jats:p>Cervical pedicle screw (PS) misplacement leads to injury of the spinal cord, nerve root, and vertebral artery. Recently, several investigators reported on the usefulness of a spinal navigation system that improves the accuracy of PS insertion. In this study, the authors assessed the accuracy of cervical pedicle, lateral mass, and odontoid screw insertions placed using a 3D fluoroscopy navigation system, the Iso-C3D unit.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>Methods<\/jats:title>\n<jats:p>In this prospective analysis of the authors' initial 50 cases of 3D fluoroscopy\u2013assisted cervical screw insertion, the authors inserted 176 PSs, 58 lateral mass screws, and 5 odontoid screws into the C1\u20137 vertebrae. They placed screws using intraoperative acquisition of data by the isocentric C-arm fluoroscope and a computer navigation system. They obtained postoperative fine-cut CT scans in all patients and assessed the accuracy of screw insertion.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>Results<\/jats:title>\n<jats:p>A PS (\u2265 3.5 mm) could be inserted into 24 (63%) of 38 pedicles at the level of C-3, 18 (53%) of 34 pedicles at C-4, 30 (65%) of 46 at C-5, 33 (80%) of 41 at C-6, and 43 (100%) of 43 at C-7. Of 176 PSs inserted into vertebrae between C-2 and C-7, 171 screws (97.2%) were classified as Grade 1 (no pedicle perforation), and 5 screws (2.8%) were classified as Grade 2 (screw perforation of the cortex by up to 2 mm). Clinically significant screw deviation in the present study was considered Grade 3 (screw perforation of the cortex by &gt; 2 mm), and this occurred in 0% of the placements.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>Conclusions<\/jats:title>\n<jats:p>In this study, the authors were able to correctly insert cervical PSs using the 3D fluoroscopy and navigation system.<\/jats:p><\/jats:sec>","DOI":"10.3171\/spi.2008.9.11.450","type":"journal-article","created":{"date-parts":[[2008,11,3]],"date-time":"2008-11-03T15:16:22Z","timestamp":1225725382000},"page":"450-453","source":"Crossref","is-referenced-by-count":108,"title":["Clinical accuracy of 3D fluoroscopy\u2013assisted cervical pedicle screw insertion"],"prefix":"10.3171","volume":"9","author":[{"given":"Yasuo","family":"Ito","sequence":"first","affiliation":[{"name":"1Department of Orthopaedic Surgery, Kobe Red Cross Hospital; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoshihisa","family":"Sugimoto","sequence":"additional","affiliation":[{"name":"1Department of Orthopaedic Surgery, Kobe Red Cross Hospital; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masao","family":"Tomioka","sequence":"additional","affiliation":[{"name":"2Department of Orthopaedic Surgery, Hyogo Emergency Medical Center, Kobe City, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yasuhiro","family":"Hasegawa","sequence":"additional","affiliation":[{"name":"2Department of Orthopaedic Surgery, Hyogo Emergency Medical Center, Kobe City, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kie","family":"Nakago","sequence":"additional","affiliation":[{"name":"1Department of Orthopaedic Surgery, Kobe Red Cross Hospital; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yukihisa","family":"Yagata","sequence":"additional","affiliation":[{"name":"1Department of Orthopaedic Surgery, Kobe Red Cross Hospital; and"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1-0090450","doi-asserted-by":"publisher","DOI":"10.1097\/00002517-199407010-00003"},{"key":"b2-0090450","doi-asserted-by":"crossref","first-page":"35","DOI":"10.3109\/10929080309146101","volume":"8","author":"Euler E","year":"2003","journal-title":"Comput Aided Surg"},{"key":"b3-0090450","doi-asserted-by":"publisher","DOI":"10.1097\/01.brs.0000201297.83920.a1"},{"key":"b4-0090450","doi-asserted-by":"publisher","DOI":"10.1227\/01.NEU.0000119755.71141.13"},{"key":"b5-0090450","doi-asserted-by":"publisher","DOI":"10.1097\/01.brs.0000147742.20637.49"},{"key":"b6-0090450","first-page":"71","volume":"33","author":"Ito Y","year":"2007","journal-title":"J Western Japanese Res Soc Spine"},{"key":"b7-0090450","first-page":"387","volume":"49","author":"Ito Y","year":"2005","journal-title":"Central Japan J Orthop Surg Traumatol"},{"key":"b8-0090450","doi-asserted-by":"publisher","DOI":"10.1097\/00002517-199407030-00004"},{"key":"b9-0090450","doi-asserted-by":"publisher","DOI":"10.1097\/00007632-199705010-00009"},{"key":"b10-0090450","doi-asserted-by":"publisher","DOI":"10.1097\/00007632-199703010-00005"},{"key":"b11-0090450","doi-asserted-by":"publisher","DOI":"10.3171\/spi.2003.99.3.0257"},{"key":"b12-0090450","doi-asserted-by":"publisher","DOI":"10.1097\/BRS.0b013e318068661e"},{"key":"b13-0090450","doi-asserted-by":"publisher","DOI":"10.1097\/00007632-199411001-00007"},{"key":"b14-0090450","doi-asserted-by":"publisher","DOI":"10.1007\/s005860000146"},{"key":"b15-0090450","doi-asserted-by":"publisher","DOI":"10.1097\/01.brs.0000192297.07709.5d"},{"key":"b16-0090450","doi-asserted-by":"publisher","DOI":"10.1097\/01.brs.0000252094.64857.ab"},{"key":"b17-0090450","doi-asserted-by":"publisher","DOI":"10.1097\/01.brs.0000182275.31425.cd"},{"key":"b18-0090450","doi-asserted-by":"publisher","DOI":"10.1097\/01.brs.0000210263.87578.65"}],"container-title":["Journal of Neurosurgery: Spine"],"original-title":[],"link":[{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg-spine\/9\/5\/article-p450.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg-spine\/9\/5\/article-p450.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,5,29]],"date-time":"2021-05-29T00:25:17Z","timestamp":1622247917000},"score":1,"resource":{"primary":{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg-spine\/9\/5\/article-p450.xml"}},"subtitle":["Clinical article"],"short-title":[],"issued":{"date-parts":[[2008,11]]},"references-count":18,"journal-issue":{"issue":"5"},"URL":"https:\/\/doi.org\/10.3171\/spi.2008.9.11.450","relation":{},"ISSN":["1547-5654"],"issn-type":[{"value":"1547-5654","type":"print"}],"subject":[],"published":{"date-parts":[[2008,11]]}}}