Vet Comp Orthop Traumatol 2022; 35(06): 370-380
DOI: 10.1055/s-0042-1750056
Original Research

Accuracy and Safety of Neuronavigation for Minimally Invasive Stabilization in the Thoracolumbar Spine Using Polyaxial Screws-Rod: A Canine Cadaveric Proof of Concept

1   Division of Surgery, Department of Clinical Veterinary Medicine, Vetsuisse Faculty, University of Bern, Bern, Switzerland
,
1   Division of Surgery, Department of Clinical Veterinary Medicine, Vetsuisse Faculty, University of Bern, Bern, Switzerland
,
Christina Precht
2   Division of Clinical Radiology, Department of Clinical Veterinary Medicine, Vetsuisse Faculty, University of Bern, Bern, Switzerland
,
Justus M.K. Rathmann
3   Institute of Sociology, University of Zurich, Zurich, Switzerland
,
1   Division of Surgery, Department of Clinical Veterinary Medicine, Vetsuisse Faculty, University of Bern, Bern, Switzerland
› Author Affiliations
Funding None.

Abstract

Objectives The main aim of this study was to evaluate the feasibility of minimally invasive stabilization with polyaxial screws-rod using neuronavigation and to assess accuracy and safety of percutaneous drilling of screw corridors using neuronavigation in thoracolumbar spine and compare it between an experienced and a novice surgeon.

Study Design Feasibility of minimally invasive polyaxial screws-rod fixation using neuronavigation was first performed in the thoracolumbar spine of two dogs. Accuracy and safety of drilling screw corridors percutaneously by two surgeons from T8 to L7 in a large breed dog using neuronavigation were established by comparing entry and exit points coordinates deviations on multiplanar reconstructions between preoperative and postoperative datasets and using a vertebral cortical breach grading scheme.

Results Feasibility of minimally invasive stabilization was demonstrated. For the experienced surgeon, safety was 100% and mean (standard deviation) entry point deviations were 0.3 mm (0.8 mm) lateral, 1.3 mm (0.8 mm) ventral and 0.7 mm (1.8 mm) caudal. The exit points deviations were 0.8 mm (1.9 mm) lateral, 0.02 mm (0.9 mm) dorsal and 0.7 mm (2.0 mm) caudal. Significant difference in accuracy between surgeons was found in the thoracic region but not in the lumbar region. Accuracy and safety improvement are noted for the thoracic region when procedures were repeated by the novice.

Conclusion This proof of concept demonstrates that using neuronavigation, minimally invasive stabilization with polyaxial screws-rod is feasible and safe in a large breed dog model.

Authors' Contributions

J.G. and E.S. executed the experiments and registered the data. J.R. did statistical analysis. J.G., E.S., F.F., C.P., and J.R. interpreted and critically revised the manuscript for important intellectual contribution. All the authors approved the final version.




Publication History

Received: 21 September 2021

Accepted: 04 May 2022

Article published online:
27 June 2022

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