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[Spinal navigation for posterior cervical and cervicothoracic instrumentation].

Abstract

OBJECTIVE

Safe placement of posterior cervical or high-thoracic pedicle screws, transarticular screws C1/2, translaminar screws C2 or cervical lateral mass screws under the guidance of spinal navigation.

INDICATIONS

All posterior cervical and cervicothoracic instrumentation with screws: instabilities and deformities of rheumatoid, traumatic, neoplastic, infectious, iatrogenic or congenital origin; multilevel cervical spinal stenosis with degenerative instability or kyphosis of the affected spinal segment.

CONTRAINDICATIONS

There are no absolute contraindications.

SURGICAL TECHNIQUE

Prone position on a gel mattress, rigid head fixation, e.g., with Mayfield tongs; if appropriate, closed reduction under lateral image intensification; midline posterior surgical approach at the level of the segments to be instrumented; if necessary, open reduction; insertion of the cervical/upper thoracic screws under the guidance of spinal navigation; if necessary, posterior decompression; instrumentation longitudinal rods; if a fusion is to be obtained, decortication of the posterior bone elements with a high-speed burr and onlay of cancellous bone or bone substitutes.

POSTOPERATIVE MANAGEMENT

In stable instrumentation, no postoperative immobilization with cervical collar is necessary. Drain removal on postoperative day 2-3, suture removal on postoperative day 14, clinical and x‑ray control 3 and 12 months after surgery or in case of clinical or neurological deterioration.

RESULTS

Numerous studies showed that the use of spinal navigation reduces implant malplacement rates significantly. Furthermore, it allows a reduction of the radiation dose for the operation team up to 90%.

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  • Authors+Show Affiliations

    ,

    Wirbelsäulenzentrum, St.-Josefs Hospital GmbH, Beethovenstraβe 20, 65189, Wiesbaden, Deutschland. mrichter@joho.de.

    Wirbelsäulenzentrum, St.-Josefs Hospital GmbH, Beethovenstraβe 20, 65189, Wiesbaden, Deutschland.

    Source

    Pub Type(s)

    English Abstract
    Journal Article
    Review

    Language

    ger

    PubMed ID

    31197402

    Citation

    Richter, M, and D Ploux. "[Spinal Navigation for Posterior Cervical and Cervicothoracic Instrumentation]." Operative Orthopadie Und Traumatologie, 2019.
    Richter M, Ploux D. [Spinal navigation for posterior cervical and cervicothoracic instrumentation]. Oper Orthop Traumatol. 2019.
    Richter, M., & Ploux, D. (2019). [Spinal navigation for posterior cervical and cervicothoracic instrumentation]. Operative Orthopadie Und Traumatologie, doi:10.1007/s00064-019-0610-z.
    Richter M, Ploux D. [Spinal Navigation for Posterior Cervical and Cervicothoracic Instrumentation]. Oper Orthop Traumatol. 2019 Jun 13; PubMed PMID: 31197402.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - [Spinal navigation for posterior cervical and cervicothoracic instrumentation]. AU - Richter,M, AU - Ploux,D, Y1 - 2019/06/13/ PY - 2019/01/14/received PY - 2019/03/06/accepted PY - 2019/03/02/revised PY - 2019/6/15/entrez KW - C2 vertebra KW - Cervical vertebra axis KW - Computer-assisted surgery KW - Image-guided surgery KW - Pedicel screws KW - Postoperative complications KW - Spine JF - Operative Orthopadie und Traumatologie JO - Oper Orthop Traumatol N2 - OBJECTIVE: Safe placement of posterior cervical or high-thoracic pedicle screws, transarticular screws C1/2, translaminar screws C2 or cervical lateral mass screws under the guidance of spinal navigation. INDICATIONS: All posterior cervical and cervicothoracic instrumentation with screws: instabilities and deformities of rheumatoid, traumatic, neoplastic, infectious, iatrogenic or congenital origin; multilevel cervical spinal stenosis with degenerative instability or kyphosis of the affected spinal segment. CONTRAINDICATIONS: There are no absolute contraindications. SURGICAL TECHNIQUE: Prone position on a gel mattress, rigid head fixation, e.g., with Mayfield tongs; if appropriate, closed reduction under lateral image intensification; midline posterior surgical approach at the level of the segments to be instrumented; if necessary, open reduction; insertion of the cervical/upper thoracic screws under the guidance of spinal navigation; if necessary, posterior decompression; instrumentation longitudinal rods; if a fusion is to be obtained, decortication of the posterior bone elements with a high-speed burr and onlay of cancellous bone or bone substitutes. POSTOPERATIVE MANAGEMENT: In stable instrumentation, no postoperative immobilization with cervical collar is necessary. Drain removal on postoperative day 2-3, suture removal on postoperative day 14, clinical and x‑ray control 3 and 12 months after surgery or in case of clinical or neurological deterioration. RESULTS: Numerous studies showed that the use of spinal navigation reduces implant malplacement rates significantly. Furthermore, it allows a reduction of the radiation dose for the operation team up to 90%. SN - 1439-0981 UR - https://www.unboundmedicine.com/medline/citation/31197402/[Spinal_navigation_for_posterior_cervical_and_cervicothoracic_instrumentation] L2 - https://doi.org/10.1007/s00064-019-0610-z DB - PRIME DP - Unbound Medicine ER -