Purpose <p>To evaluate the clinical value of a two-dimensional(2D) computer navigation system in percutaneous pedicle screw fixation for thoracic spine fractures.</p> Methods <p>A retrospective study was conducted on 74 patients with acute thoracic fractures who underwent pedicle screw fixation at Fujian Provincial Hospital from January 2019 to January 2022. Patients were divided into a navigation group (<i>n</i> = 34) using 2D navigation-assisted percutaneous screw placement, and a conventional group (<i>n</i> = 40) undergoing freehand screw placement. Screw placement accuracy (Rampersaud grading), intraoperative fluoroscopy times, operative time, blood loss, postoperative pain (VAS scores), and complications were compared.</p> Results <p>The navigation group showed a significantly higher screw accuracy rate (Grades A–B: 94.1% vs. 79.2%, <i>P</i> &lt; 0.001). Fluoroscopy frequency (8.0 ± 1.1 vs. 16.0 ± 2.0, <i>P</i> &lt; 0.001), operative time (90.1 ± 15.5&#xa0;min vs. 98.1 ± 14.2&#xa0;min, <i>P</i> &lt; 0.05), and blood loss (50.4 ± 11.1 mL vs. 110.3 ± 17.8 mL, <i>P</i> &lt; 0.001) were all significantly lower in the navigation group. Postoperative VAS scores were significantly lower at 1 week and 1 month (<i>P</i> &lt; 0.001), with no difference at 3 months. Complications included 9 cases of transient neurological symptoms and 2 cases of screw loosening, all without lasting sequelae.</p> Conclusion <p>2D computer navigation–assisted percutaneous pedicle screw fixation improves screw placement accuracy, reduces radiation exposure, and facilitates early postoperative pain relief. These findings support its potential as a practical tool for managing thoracic spine fractures.</p>

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Clinical observation on the effect of percutaneous pedicle screw fixation assisted by 2D computer navigation in the treatment of thoracic spine fractures

  • Yongfa Zhang,
  • Qi Fang,
  • Qi Li,
  • Hao Lin,
  • Weiqiang Wu,
  • Tie Ke

摘要

Purpose

To evaluate the clinical value of a two-dimensional(2D) computer navigation system in percutaneous pedicle screw fixation for thoracic spine fractures.

Methods

A retrospective study was conducted on 74 patients with acute thoracic fractures who underwent pedicle screw fixation at Fujian Provincial Hospital from January 2019 to January 2022. Patients were divided into a navigation group (n = 34) using 2D navigation-assisted percutaneous screw placement, and a conventional group (n = 40) undergoing freehand screw placement. Screw placement accuracy (Rampersaud grading), intraoperative fluoroscopy times, operative time, blood loss, postoperative pain (VAS scores), and complications were compared.

Results

The navigation group showed a significantly higher screw accuracy rate (Grades A–B: 94.1% vs. 79.2%, P < 0.001). Fluoroscopy frequency (8.0 ± 1.1 vs. 16.0 ± 2.0, P < 0.001), operative time (90.1 ± 15.5 min vs. 98.1 ± 14.2 min, P < 0.05), and blood loss (50.4 ± 11.1 mL vs. 110.3 ± 17.8 mL, P < 0.001) were all significantly lower in the navigation group. Postoperative VAS scores were significantly lower at 1 week and 1 month (P < 0.001), with no difference at 3 months. Complications included 9 cases of transient neurological symptoms and 2 cases of screw loosening, all without lasting sequelae.

Conclusion

2D computer navigation–assisted percutaneous pedicle screw fixation improves screw placement accuracy, reduces radiation exposure, and facilitates early postoperative pain relief. These findings support its potential as a practical tool for managing thoracic spine fractures.