{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T07:31:19Z","timestamp":1792654279707,"version":"4.5.0"},"reference-count":14,"publisher":"Georg Thieme Verlag KG","issue":"03","license":[{"start":{"date-parts":[[2022,9,20]],"date-time":"2022-09-20T00:00:00Z","timestamp":1663632000000},"content-version":"vor","delay-in-days":2210,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Asian J Neurosurg"],"published-print":{"date-parts":[[2016,9]]},"abstract":"<jats:p>\n          Background: There is a relatively high incidence of screw misplacement during spinal instrumentation due to distortion of normal anatomy following spinal trauma.\nAims and Objectives: To evaluate and share the initial experience with the use of neuro-navigated 3D O-arm\u00ae (Medtronic, USA) as compared to traditional 2D fluoroscopy in atrauma center in India. Materials and Methods: In this retrospective study, consecutive patients of spinal injury who underwent screw fixation under O-arm guidance over nine-month period (July 2010 till March 2011) were evaluated for accuracy of screw placement. An equal number of consecutive patients prior to March 2011 who underwent screw fixation in 2D fluoroscopy were included for comparison. Patient demographics and radiology were reviewed and spinal injury was assessed using the ASIA grading in both the groups. Screw placement was assessed by postoperative CT scans of the relevant spine and accuracy of screw placement and breach of the medial or lateral cortex of the pedicle were recorded for each case. Results: In the O-arm group, there were 57 patients in whom 210 screws were inserted. None of the patients had screw mal-placement. In 2D fluoroscopy group, 57 patients had 268 screws insertions. 10 (3.73%) screws were found to be malpositioned in the postoperative CT scans (8 in thoracic spine and 2 in odontoid fractures). The malposition rate was highly significant in 2D fluoroscopy thoracolumbar (P = 0.0015) subgroup. One patient had neurological deterioration and three patients required repositioning of the screws. \nConclusion: In a teaching center with multiple surgeons, the O-arm\u00e2 imaging ensures accurate placement of screws as compared to traditional 2D fluoroscopy.<\/jats:p>","DOI":"10.4103\/1793-5482.144179","type":"journal-article","created":{"date-parts":[[2014,11,7]],"date-time":"2014-11-07T07:09:46Z","timestamp":1415344186000},"page":"298-302","source":"Crossref","is-referenced-by-count":5,"title":["Usefulness of navigated O-arm\u00ae in a teaching center for spinal trauma"],"prefix":"10.1055","volume":"11","author":[{"given":"Deepak","family":"Agrawal","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, JPN Apex Trauma Centre, All India Institute of Medical Sciences, New Delhi"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2022,9,20]]},"reference":[{"key":"key-10.4103\/1793-5482.144179-1","first-page":"667","volume-title":"Management of thoracolumbar-fractures with accompanying neurological injury","author":"Lemons","year":"1992","journal-title":"Neurosurgery"},{"key":"key-10.4103\/1793-5482.144179-2","first-page":"1254","volume-title":"Improved accuracy of pedicle screw insertion with computer-assisted surgery.A prospective clinical trial of 30 patients","author":"Laine","year":"1976","journal-title":"Spine (Phila Pa"},{"key":"key-10.4103\/1793-5482.144179-3","first-page":"S184","volume-title":"Complications of lumbar spinal fusion with transpedicular instrumentation","author":"Davne","year":"1976","journal-title":"Spine (Phila Pa"},{"key":"key-10.4103\/1793-5482.144179-4","first-page":"2160","volume-title":"Transpedicular screw placement: Image-guided versus lateralview fluoroscopy: in vitro simulation","author":"Assaker","year":"1976","journal-title":"Spine (Phila Pa"},{"key":"key-10.4103\/1793-5482.144179-5","first-page":"74","volume-title":"Effect of frameless stereotaxy on theaccuracy of C1-2 transarticular screw placement","author":"Bloch","year":"2001","journal-title":"J Neurosurg"},{"key":"key-10.4103\/1793-5482.144179-6","first-page":"2503","volume-title":"Image-guided spine surgery: A cadaver study comparing conventional open laminoforaminotomy and twoimage-guided techniques for pedicle screw placement in posterolateral fusion and nonfusion models","author":"Austin","year":"1976","journal-title":"Spine (Phila Pa"},{"key":"key-10.4103\/1793-5482.144179-7","first-page":"316","volume-title":"A preliminary study of reliability of impedance measurement to detect iatrogenic initial pedicle perforation (in the porcine model)","author":"Bolger","year":"2006","journal-title":"Eur Spine J"},{"key":"key-10.4103\/1793-5482.144179-8","first-page":"2231","volume-title":"Complications associated with the technique of pedicle screw fixation.A selected survey of ABS members","author":"Esses","year":"1976","journal-title":"Spine (Phila Pa"},{"key":"key-10.4103\/1793-5482.144179-9","first-page":"E111","volume-title":"Pedicle screw placement accuracy: A meta-analysis","author":"Kosmopoulos","year":"1976","journal-title":"Spine (Phila Pa"},{"key":"key-10.4103\/1793-5482.144179-10","first-page":"E56","volume-title":"Randomized clinical study to compare the accuracy of navigated and non-navigated thoracic pedicle screws in deformity correction surgeries","author":"Rajasekaran","year":"1976","journal-title":"Spine (Phila Pa"},{"key":"key-10.4103\/1793-5482.144179-11","doi-asserted-by":"crossref","unstructured":"Nottmeier EW, Seemer W, Young PM. Placement of thoracolumbar pedicle screws using three-dimensional image guidance: Experience in a large patient cohort. J Neurosurg Spine 2009;10,33-9.","DOI":"10.3171\/2008.10.SPI08383"},{"key":"key-10.4103\/1793-5482.144179-12","first-page":"193","volume-title":"Comparison of endoscopic sinus surgery with and without image guidance","author":"Fried","year":"2002","journal-title":"Am J Rhinol"},{"key":"key-10.4103\/1793-5482.144179-13","first-page":"69","volume-title":"Occupational radiation exposure to the surgeon.J Am Acad Orthop Surg","author":"Singer","year":"2005","journal-title":""},{"key":"key-10.4103\/1793-5482.144179-14","first-page":"1555","volume-title":"Estimation of patient dose and associated radiogenic risks from fluoroscopically guided pedicle screw insertion","author":"Perisinakis","year":"1976","journal-title":"Spine (Phila Pa"}],"container-title":["Asian Journal of Neurosurgery"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.4103\/1793-5482.144179.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,9,20]],"date-time":"2022-09-20T23:06:50Z","timestamp":1663715210000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.4103\/1793-5482.144179"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2016,9]]},"references-count":14,"journal-issue":{"issue":"03","published-online":{"date-parts":[[2022,9,20]]},"published-print":{"date-parts":[[2016,9]]}},"URL":"https:\/\/doi.org\/10.4103\/1793-5482.144179","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["1793-5482","2248-9614"],"issn-type":[{"value":"1793-5482","type":"print"},{"value":"2248-9614","type":"electronic"}],"subject":[],"published":{"date-parts":[[2016,9]]}}}