イノウエ　トモヒサ   Inoue Tomohisa   井上　知久    所属   医学部 医学科（東京女子医科大学病院）    職種   助教
論文種別	原著
言語種別	英語
査読の有無	査読あり
表題	Surgical Results of Intraoperative C-arm Fluoroscopy Versus O-arm in Transarticular Screw Fixation for Atlantoaxial Instability.
掲載誌名	正式名：World neurosurgery 略　 称：World Neurosurg ISSNコード：18788769/18788750
掲載区分	国外
巻・号・頁	139,pp.e686-e690
著者・共著者	Wada Keiji, Inoue Tomohisa, Hagiwara Kenji, Tamaki Ryo, Okazaki Ken
担当区分	2nd著者
発行年月	2020/07
概要	OBJECTIVE:This study compared the surgical results of transarticular screw (TAS) fixation for atlantoaxial instability between C-arm fluoroscopy and O-arm.METHODS:Of 58 patients who underwent TAS fixation for atlantoaxial instability, 35 underwent C-arm-assisted surgery (C-group) and 23 underwent O-arm-assisted surgery (O-group). In total, 78 TASs were placed: 39 in the C-group and 39 in the O-group. Unilateral and bilateral TAS fixation was performed in 38 and 20 patients, respectively. All patients underwent Brook's procedure with TAS. TAS fixation accuracy on postoperative computed tomography, operative time, intraoperative bleeding, perioperative complications, and bone union were evaluated. Screw accuracy was assessed using Neo's classification: grade (G) 0, no perforation; G1, perforation <2 mm; G2, perforation 2-4 mm; G3, perforation >4 mm.RESULTS:TAS fixation accuracy was greater in the O-group than the C-group: G0: 38, 97.4%; G1: 1, 2.6% (O-group) vs G0: 22, 56.4%; G1: 11, 28.2%; G2: 3, 7.7%; G3: 3, 7.7% (C-group) (P < 0.001). Median operative time and median blood loss were similar between both groups. Bone union rate was greater with bilateral than unilateral TAS fixation (P < 0.05). There were no complications regarding screw malposition. Deep wound infection was observed in 1 case in the C-group.CONCLUSIONS:O-arm use improved TAS fixation accuracy. Blood loss was equivalent between the groups. O-arm-assisted TAS fixation did not prolong operative time despite the time required for setting and scanning. The O-arm is safe and useful for TAS fixation in atlantoaxial instability.
DOI	10.1016/j.wneu.2020.04.109
PMID	32339745