Comparison of two-dimensional and three-dimensional fluoroscopy-based navigation in percutaneous sacroiliac screw internal fixation

Abstract

Objective To compare the advantages and disadvantages of using intraoperative 2 dimensional (2D)-fluoroscopy-based navigation technique and 3 D technique used in percutaneous sacroiliac screw internal fixation,and to find a simple and safe operative method by combined the advantages of the two navigation techniques.Methods From June 2008 to October 2012,we retrospective analyzed 41 cases subject to percutaneous sacroiliac screw fixation.The cases were divided into three groups of A,B,and C according to the operation method:group A,2D-navigation technique; group B,3D-navigation technique; group C:insertion of a guiding pin first with 2D navigation,verification with 3D fluoroscopy and then fixation with cannulated screw.The time of screw insertion,the time of fluoroscopy,and the times of penetrating the vertebrae cortex were compared.Methods We totally used 44 nails,and the mean time of screw insertion in groups A,B and C was (51.2 ± 5.6),(67.7 ± 10.7) and (55.3 ± 4.0) min respectively.The mean fluoroscopy times in groups A,B and C were (74.7 ± 5.6),(144.1 ± 2.1) and (104.3 ±1.0).One screw in the group A penetrated the S1 vertebrae cortex,and the rest two groups had no penetration of nails across the S1 vertebrae cortex.Conclusion Combining the advantages and disadvantages of 2D and 3D navigation,the method of inserting a guiding pin with 2D navigation,and using 3D fluoroscopy to verify it,would not only take less time of operation and fluoroscopy,but also has the same screw accuracy rate as using the 3D navigation technique. Key words: Computer navigation system; Sacroiliac screw; Internal fixation