Comparison of accuracy in C1–C2 pedicle screw placement: O-arm, 3D guides, and C-arm fluoroscopy

作者：Yuwei Li, Haijiao Wang, Xian‐Fang Li, Cui Wei, Peng Zhou, Wei Xiao, Zimin Wang · 发表于：Scientific Reports · 年份：2025 · DOI：10.1038/s41598-025-99884-y · 被引用次数：6 · 研究领域：Spinal Fractures and Fixation Techniques、Spine and Intervertebral Disc Pathology、Pelvic and Acetabular Injuries

To evaluate the accuracy and safety of C1-C2 pedicle screw placement using O-arm navigation, individualized 3D-printed guides, and C-arm fluoroscopy. Clinical data of 47 patients who underwent C1-C2 spinal fixation surgery at our institution between January 2015 and December 2020 were retrospectively analyzed. The cohort included 28 males and 19 females, aged 15-59 years (mean age: 46.23 ± 9.97 years). Patients were categorized into three groups based on the screw placement technique: navigation group (11 cases; O-arm S8 navigation system), guide group (15 cases; individualized 3D-printed guides), and fluoroscopy group (21 cases; C-arm fluoroscopy guided by anatomical landmarks). Outcome measures included surgical time, screw placement time, intraoperative blood loss, single-pass screw placement success rate, screw placement accuracy, and complication rate. Surgical Metrics: The Navigation group demonstrated a mean surgical time of 120.72 ± 11.14 min, screw placement time of 20.00 ± 1.09 min, and blood loss of 225.81 ± 25.58 ml. The Guide group reported significantly shorter surgical time (97.46 ± 9.03 min, P < 0.001), shorter screw placement time (15.80 ± 1.93 min, P < 0.001), and reduced blood loss (162.66 ± 18.52 ml, P < 0.001). The Fluoroscopy group showed longer surgical time (121.04 ± 12.81 min) and higher blood loss (239.04 ± 24.54 ml) compared to the other groups. Screw Placement Success and Accuracy: A total of 188 screws were placed (44 in the Navigation group, 60; ...