目的: We used the O arm system in different kinds of complex spine surgery in the past 1 years including Minimally invasive trasforaminal interbody fusion(MIS TLIF), scoliosis, revision spine surgery, hemivertebral resection. The aim of the study is to share the experience of using O arm with others.
 

方法: From Dec.2015 to July 2017, we used the O arm navigation in different kinds of spine surgeries. Totally 89 cases using O arm navigation including idiopathic scoliosis, congenital scoliosis, MIS-TLIF, burst fractures and recurrent spine metastases for corpectomy. All the cases accepted intraoperative O arm navigation technique. In the recurrent spine tumor case, we use O arm for bony landmark detection and O arm assisted tumor resection. In the scoliosis case, we use O arm navigation to guide the pedicle screw insertion. In congenital scoliosis, we use the O arm navigation to guide the pedicle screw insertion and hemivertebral corpectomy. In the MIS TLIF cases, we use the O arm navigation for cage insertion procedure, facetectomy and screw insertion through a whiltse approach. In the burst fracture cases, we use MIS whiltse approach for pedicle screw insertion. All the cases had accepted post-operative x ray follow up to confirm the cage and pedicle screw position. All the cases accepted out patient department follow up including medical records and x ray.

结果: In congenital scoliosis cases, the vertebrectomy could be done accurately. In the MIS TLIF cases, O arm scan was use for only 1 time, no problem of accuracy was noted. In the scoliosis cases, O arm scanning numbers was determined by the numbers of planned instrumented spinal segment, and 3 times of O arm scan (5 segments for each scan) was used in most of cases. The radiation dose is equal to 1 times of chest CT for 3 times of O arm scan. In All the 89 cases, only 1 pedicle screw had breech position in the period of initial learning phase. 1 dural tear was noted in the MIS TLIF cases in the 3^rd MIS TLIF case. No other complication was noted. All the pedicle screws position in the scoliosis cases were acceptable proved by post-operative x ray or intra-operative O arm scan.
 

结论: O arm navigation seems to have the following characters including high accuracy, easy access, and quick registration time. After following the rules to avoid technical error, the accuracy of O arm is certainly not a problem to worry about.