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Review
. 2017 Feb;7(1):83-94.
doi: 10.1055/s-0036-1583942. Epub 2017 Feb 1.

Differences between Manufacturers of Computed Tomography-Based Computer-Assisted Surgery Systems Do Exist: A Systematic Literature Review

Anas Nooh  1   2   3 , Joushua Lubov  1   3 , Ahmed Aoude  1 , Sultan Aldebeyan  1   4 , Peter Jarzem  1 , Jean Ouellet  1 , Michael H Weber  1
Affiliations
Review

Differences between Manufacturers of Computed Tomography-Based Computer-Assisted Surgery Systems Do Exist: A Systematic Literature Review

Anas Nooh et al. Global Spine J. 2017 Feb.

Abstract

Study design: Literature review.

Objective: Several studies have shown that the accuracy of pedicle screw placement significantly improves with use of computed tomography (CT)-based navigation systems. Yet, there has been no systematic review directly comparing accuracy of pedicle screw placement between different CT-based navigation systems. The objective of this study is to review the results presented in the literature and compare CT-based navigation systems relative only to screw placement accuracy.

Methods: Data sources included CENTRAL, Medline, PubMed, and Embase databases. Studies included were randomized clinical trials, case series, and case-control trials reporting the accuracy of pedicle screws placement using CT-based navigation. Two independent reviewers extracted the data from the selected studies that met our inclusion criteria. Publications were grouped based on the CT-based navigation system used for pedicle screw placement.

Results: Of the 997 articles we screened, only 26 met all of our inclusion criteria and were included in the final analysis, which showed a significant statistical difference (p < 0.0001, 95% confidence interval 0.92 to 1.23) in accuracy of pedicle screw placement between three different CT-based navigation systems. The mean (weighted) accuracy of pedicle screws placement based on the CT-based navigation system was found to be 97.20 ± 2.1% in StealthStation (Medtronic, United States) and 96.1 ± 3.9% in VectorVision (BrainLab, Germany).

Conclusion: This review summarizes results presented in the literature and compares screw placement accuracy using different CT-based navigation systems. Although certain factors such as the extent of the procedure and the experience and skills of the surgeon were not accounted for, the differences in accuracy demonstrated should be considered by spine surgeons and should be validated for effects on patients' outcome.

Keywords: CT navigation; computer assisted surgery; manufacturer; pedicle screw; spine surgery.

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Figures

Fig. 1
Fig. 1
Graphical depiction of the systematic article selection process used. Abbreviation: CT, computed tomography.
See this image and copyright information in PMC

References

    1. Merloz P, Tonetti J, Pittet L, Coulomb M, Lavalleé S, Sautot P. Pedicle screw placement using image guided techniques. Clin Orthop Relat Res 1998;(354):39–48 - PubMed
    1. Schulze CJ, Munzinger E, Weber U. Clinical relevance of accuracy of pedicle screw placement. A computed tomographic-supported analysis. Spine (Phila Pa 1976) 1998;2320):2215–2220, discussion 2220–2221 - PubMed
    1. Vaccaro AR, Rizzolo SJ, Allardyce TJ, et al. Placement of pedicle screws in the thoracic spine. Part I: Morphometric analysis of the thoracic vertebrae. J Bone Joint Surg Am 1995;778):1193–1199 - PubMed
    1. Krag MH. Biomechanics of thoracolumbar spinal fixation. A review. Spine (Phila Pa 1976) 1991;16(3, Suppl):S84–S99 - PubMed
    1. Laine T, Lund T, Ylikoski M, Lohikoski J, Schlenzka D. Accuracy of pedicle screw insertion with and without computer assistance: a randomised controlled clinical study in 100 consecutive patients. Eur Spine J 2000;93):235–240 - PMC - PubMed

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