dc.contributor.author
Wessels, Lars
dc.contributor.author
Komm, Bettina
dc.contributor.author
Bohner, Georg
dc.contributor.author
Vajkoczy, Peter
dc.contributor.author
Hecht, Nils
dc.date.accessioned
2023-07-14T13:47:24Z
dc.date.available
2023-07-14T13:47:24Z
dc.identifier.uri
https://refubium.fu-berlin.de/handle/fub188/40091
dc.identifier.uri
http://dx.doi.org/10.17169/refubium-39813
dc.description.abstract
Computer-assisted spine surgery based on preoperative CT imaging may be hampered by sagittal alignment shifts due to an intraoperative switch from supine to prone. In the present study, we systematically analyzed the occurrence and pattern of sagittal spinal alignment shift between corresponding preoperative (supine) and intraoperative (prone) CT imaging in patients that underwent navigated posterior instrumentation between 2014 and 2017. Sagittal alignment across the levels of instrumentation was determined according to the C2 fracture gap (C2-F) and C2 translation (C2-T) in odontoid type 2 fractures, next to the modified Cobb angle (CA), plumbline (PL), and translation (T) in subaxial pathologies. One-hundred and twenty-one patients (C1/C2: n = 17; C3-S1: n = 104) with degenerative (39/121; 32%), oncologic (35/121; 29%), traumatic (34/121; 28%), or infectious (13/121; 11%) pathologies were identified. In the subaxial spine, significant shift occurred in 104/104 (100%) cases (CA: *p = .044; T: *p = .021) compared to only 10/17 (59%) cases that exhibited shift at the C1/C2 level (C2-F: **p = .002; C2-T: *p < .016). The degree of shift was not affected by the anatomic region or pathology but significantly greater in cases with an instrumentation length > 5 segments (" increment PL > 5 segments": 4.5 +/- 1.8 mm; " increment PL <= 5 segments": 2 +/- 0.6 mm; *p = .013) or in revision surgery with pre-existing instrumentation (" increment PL presence": 5 +/- 2.6 mm; " increment PL absence": 2.4 +/- 0.7 mm; **p = .007). Interestingly, typical morphological instability risk factors did not influence the degree of shift. In conclusion, intraoperative spinal alignment shift due to a change in patient position should be considered as a cause for inaccuracy during computer-assisted spine surgery and when correcting spinal alignment according to parameters that were planned in other patient positions.
en
dc.rights.uri
https://creativecommons.org/licenses/by/4.0/
dc.subject
Computer-assisted spine surgery
en
dc.subject
Intraoperative imaging
en
dc.subject
Spinal alignment shift
en
dc.subject.ddc
600 Technik, Medizin, angewandte Wissenschaften::610 Medizin und Gesundheit::610 Medizin und Gesundheit
dc.title
Spinal alignment shift between supine and prone CT imaging occurs frequently and regardless of the anatomic region, risk factors, or pathology
dc.type
Wissenschaftlicher Artikel
dcterms.bibliographicCitation.doi
10.1007/s10143-021-01618-x
dcterms.bibliographicCitation.journaltitle
Neurosurgical Review
dcterms.bibliographicCitation.number
1
dcterms.bibliographicCitation.originalpublishername
Springer Nature
dcterms.bibliographicCitation.pagestart
855
dcterms.bibliographicCitation.pageend
863
dcterms.bibliographicCitation.volume
45
refubium.affiliation
Charité - Universitätsmedizin Berlin
refubium.resourceType.isindependentpub
no
dcterms.accessRights.openaire
open access
dcterms.bibliographicCitation.pmid
34379226
dcterms.isPartOf.issn
0344-5607
dcterms.isPartOf.eissn
1437-2320