3D-Imaging navigation in posterior pelvic iliosacral screwing using the Surgivisio® system.

Abstract

The recent studies about iliosacral screws performed with navigation systems show promising results. The Surgivisio system is a new generation of intraoperative 3D imaging technique used in our institution since two years. The aim of this prospective study was to evaluate the accuracy of iliosacral screw placement and radiation exposure with the Surgivisio® system.Between January 2018 and December 2019, every patient operated for percutaneous iliosacral screwing using the Surgivisio® system were included in this prospective single center study. Accuracy of screw placement was assessed with post-operative high- resolution CT-scan. Operative time, radiation exposure and complications were assessed.A total of 32 patients were included with 49 iliosacral screws. Using the modified Gras classification, 2% (1/49) were rated as misplaced and 2% (1/49) were repositioned. The mean operative time was 26 min for the whole procedure. The mean dose area product was 7.98 Gy.cm2. Two complications were recorded (neurological pain treated by removal of the misplaced screw, an asymptomatic cement leakage with one augmented iliosacral screw).The Surgivisio® system is an efficient navigation tool for iliosacral screwing in minimal invasive surgery. It improves the accuracy of screw placement with an acceptable radiation exposure and operative time.