LAUSR

OBJECTIVE To compare the accuracy of C-arm fluoroscopy versus O-arm assisted pedicle screw (PS) placement in the cervicothoracic spinal junction (CTSJ). METHODS Patients who underwent PS placement in the CTSJ (C7-T4) at our hospital were included in this study. Of 37 patients who underwent PS placement in the CTSJ, 20 underwent intraoperative C-arm fluoroscopy-assisted surgery (C-group) and 17 underwent intraoperative O-arm-assisted surgery (O-group). In total, 159 PSs were placed-73 in the C-group and 86 in the O-group. The accuracy of PS placement was compared between the C-group and the O-group using the classification proposed by Gertzbein and Robbins to analyze pedicle violation. RESULTS PS accuracy was higher in the O-group than in the C-group; PS placement evaluated as Grade A, representing no perforation, was 95.3% (82/86) for the O-group, whereas it was 78.1% (57/73) for the C-group. There was a clear statistically significant difference in accuracy of PS placement between the groups (P = 0.0013). CONCLUSION O-arm-assisted surgery improved the accuracy of PS placement in the CTSJ.