{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T19:20:30Z","timestamp":1787772030879,"version":"build-2784847793"},"reference-count":15,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2024,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>We report the use of computerized tomography (CT)-guided navigation for complex spinal deformity correction (anterior and posterior) in an 8-year-old patient with neurofibromatosis complicated by dystrophic pedicles, dural ectasia, and extensive vertebral scalloping. A retrospective review was conducted of the patient\u2019s medical records for the past 3 years, including the patient\u2019s office visit notes, operative reports, pre- and 2-year postoperative imaging studies. The patient successfully underwent anterior lumbar interbody fusion from L3\u2013S1 using CT-guided navigation to negotiate the challenges posed by dural ectasia and vertebral body scalloping. One week after the anterior procedure, she underwent navigation-guided T10-to-pelvis posterior instrumented fusion. There were no perioperative or postoperative complications at 2 years. In patients with complex deformities of the spine, including dural ectasia, scalloped vertebral bodies, and decreased pedicle integrity, the use of intraoperative CT-guided navigation can benefit surgeons by facilitating the safe placement of interbody spacers and pedicle screws.<\/jats:p>","DOI":"10.4103\/jcvjs.jcvjs_144_23","type":"journal-article","created":{"date-parts":[[2024,3,13]],"date-time":"2024-03-13T07:02:56Z","timestamp":1710313376000},"page":"114-117","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":1,"title":["Use of navigation for anterior and posterior instrumentation in the surgical management of pediatric pathologic lumbosacral deformity"],"prefix":"10.4103","volume":"15","author":[{"given":"Sassan","family":"Keshavarzi","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Tulane University School of Medicine, New Orleans, LA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeffrey","family":"Spardy","sequence":"additional","affiliation":[{"name":"Herbert Wertheim College of Medicine, Florida International University, Miami, FL, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Subaraman","family":"Ramchandran","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Nicklaus Children\u2019 s Hospital, Miami, FL, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephen","family":"George","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Nicklaus Children\u2019 s Hospital, Miami, FL, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2024,3,13]]},"reference":[{"key":"R1-20240904","doi-asserted-by":"crossref","first-page":"88","DOI":"10.1002\/(SICI)1522-712X(1995)1:2<88::AID-IGS3>3.0.CO;2-H","article-title":"Computer-aided fixation of spinal implants","volume":"1","author":"Nolte","year":"1995","journal-title":"J Image Guid Surg"},{"key":"R2-20240904","doi-asserted-by":"crossref","first-page":"E298","DOI":"10.1097\/BSD.0b013e31828af33e","article-title":"Comparison of navigated versus non-navigated pedicle screw placement in 260 patients and 1434 screws: Screw accuracy, screw size, and the complexity of surgery","volume":"28","author":"Luther","year":"2015","journal-title":"J Spinal Disord Tech"},{"key":"R3-20240904","first-page":"1905","article-title":"Spinal navigation with intra-operative 3D-imaging modality in lumbar pedicle screw fixation","volume":"88","author":"Yu","year":"2008","journal-title":"Zhonghua Yi Xue Za Zhi"},{"key":"R4-20240904","doi-asserted-by":"crossref","first-page":"113","DOI":"10.3171\/2012.5.SPINE11399","article-title":"Pedicle screw navigation: A systematic review and meta-analysis of perforation risk for computer-navigated versus freehand insertion","volume":"17","author":"Shin","year":"2012","journal-title":"J Neurosurg Spine"},{"key":"R5-20240904","doi-asserted-by":"crossref","first-page":"606","DOI":"10.3171\/2010.5.SPINE09993","article-title":"Clinical accuracy of three-dimensional fluoroscopy-based computer-assisted cervical pedicle screw placement: A retrospective comparative study of conventional versus computer-assisted cervical pedicle screw placement","volume":"13","author":"Ishikawa","year":"2010","journal-title":"J Neurosurg Spine"},{"key":"R6-20240904","doi-asserted-by":"crossref","first-page":"E56","DOI":"10.1097\/01.brs.0000252094.64857.ab","article-title":"Randomized clinical study to compare the accuracy of navigated and non-navigated thoracic pedicle screws in deformity correction surgeries","volume":"32","author":"Rajasekaran","year":"2007","journal-title":"Spine (Phila Pa 1976)"},{"key":"R7-20240904","doi-asserted-by":"crossref","first-page":"1543","DOI":"10.1097\/BRS.0b013e318068661e","article-title":"Accuracy analysis of pedicle screw placement in posterior scoliosis surgery: Comparison between conventional fluoroscopic and computer-assisted technique","volume":"32","author":"Kotani","year":"2007","journal-title":"Spine (Phila Pa 1976)"},{"key":"R8-20240904","doi-asserted-by":"crossref","first-page":"E473","DOI":"10.1097\/BRS.0b013e318238bbd9","article-title":"Computed tomography-guided navigation of thoracic pedicle screws for adolescent idiopathic scoliosis results in more accurate placement and less screw removal","volume":"37","author":"Ughwanogho","year":"2012","journal-title":"Spine (Phila Pa 1976)"},{"key":"R9-20240904","first-page":"19","article-title":"Cotrel-Dubousset Instrumentation in Neurofibromatosis Spine Curves: A Preliminary Report","volume":"245","author":"Holt","journal-title":"Clin Orthop Relat Res 1989"},{"key":"R10-20240904","doi-asserted-by":"crossref","first-page":"53","DOI":"10.1097\/00003086-198908000-00010","article-title":"Scoliosis surgery in neurofibromatosis","volume":"245","author":"Betz","year":"1989","journal-title":"Clin Orthop Relat Res"},{"key":"R11-20240904","doi-asserted-by":"crossref","first-page":"1569","DOI":"10.1007\/s00586-010-1464-0","article-title":"Surgical correction of severe dystrophic neurofibromatosis scoliosis: An experience of 32 cases","volume":"19","author":"Koptan","year":"2010","journal-title":"Eur Spine J"},{"key":"R12-20240904","doi-asserted-by":"crossref","first-page":"E7","DOI":"10.3171\/2022.2.FOCUS21790","article-title":"Management and surgical outcomes of dystrophic scoliosis in neurofibromatosis type 1: A systematic review","volume":"52","author":"Neifert","year":"2022","journal-title":"Neurosurg Focus"},{"key":"R13-20240904","doi-asserted-by":"crossref","first-page":"413","DOI":"10.3171\/2020.6.SPINE20898","article-title":"Assessing the unique characteristics associated with surgical treatment of dystrophic lumbar scoliosis secondary to neurofibromatosis type 1: A single-center experience of more than 10 years","volume":"34","author":"Li","year":"2020","journal-title":"J Neurosurg Spine"},{"key":"R14-20240904","doi-asserted-by":"crossref","first-page":"1729","DOI":"10.1007\/s00586-015-4012-0","article-title":"Does intraoperative navigation improve the accuracy of pedicle screw placement in the apical region of dystrophic scoliosis secondary to neurofibromatosis type I: Comparison between O-arm navigation and free-hand technique","volume":"25","author":"Jin","year":"2016","journal-title":"Eur Spine J"},{"key":"R15-20240904","doi-asserted-by":"crossref","first-page":"132","DOI":"10.1097\/BSD.0000000000001069","article-title":"Combined anterior-posterior versus posterior-only spinal fusion in treating dystrophic neurofibromatosis scoliosis with modern instrumentation: A systematic review and meta-analysis","volume":"34","author":"Jia","year":"2021","journal-title":"Clin Spine Surg"}],"container-title":["Journal of Craniovertebral Junction and Spine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.4103\/jcvjs.jcvjs_144_23","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T18:27:00Z","timestamp":1787768820000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.4103\/jcvjs.jcvjs_144_23"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,1]]},"references-count":15,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2024]]}},"URL":"https:\/\/doi.org\/10.4103\/jcvjs.jcvjs_144_23","relation":{},"ISSN":["0974-8237","0976-9285"],"issn-type":[{"value":"0974-8237","type":"print"},{"value":"0976-9285","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,1]]},"assertion":[{"value":"2023-10-25","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-12-31","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}