Simultaneous navigated cervico-thoracic and thoraco-lumbar fixation

Abstract

Study design: Case report. Objective: To investigate the feasibility of using two independent image guidance systems to simultaneously fix multiple segment spine fractures. Summary of background data: Image guidance is increasingly used to aid spinal fixation. We describe the first use of multiple navigation systems during a single procedure allowing for multi-segment spinal fixations to be performed simultaneously and capitalizing the advantages of navigation. Method: Two Medtronic Stealth Station S7™ systems with O-arm image capture were used to guide fixation of C6 and T12, unstable, AO A4, three-column fractures, in a patient with ankylosing spondylitis. Results: Two surgical teams were able to perform cervico-thoracic and thoraco-lumbar fixations simultaneously. Operative time was 2.5 h. Post-operative imaging showed accurate instrumentation placement. The patient recovered without any neurological sequelae. Conclusions: Optical independence of the Medtronic Stealth Station™ system allowed for simultaneous navigation guided fixation of multiple segment fractures without compromising accuracy. This may result in shortened operative time and morbidity associated with prolonged prone positioning of polytrauma patients, as well as reducing radiation exposure for theatre staff.