| Objective To assess the accuracy of 3D-CT navigation system in guiding pedicle screw fixation in the thoracic-lumbar spine.Methods 65 Thoracic-lumbar pedicle screws guided by 3D-CT navigation were placed on 13 cases, including 4 patients with thoracic spine fractures, 7 patients with lumbar spine fractures, and 2 patients with lumbar spondylolisthesis. In the traditional X-ray assisted group, 70 Thoracic-lumbar pedicle screws placement guided by X-ray fluoroscopy were performed on 14 cases, including 3 patients with thoracic spine fractures, 7 patients with lumbar spine fractures, 2 patients with lumbar spondylolisthesis, and 2 patients with lubar intervertebral disc protrusion. After the operation, the positions of all pedicle screws were evaluated with CT using the Richter grading system.Results In 3D-CT navigation guidance group :95.4﹪of the screws were excellent, 4.6﹪good, and no bad in the screws. In traditional X-ray assisted group: 81.4﹪of the screws were excellent, 14.3﹪good, and 4.3﹪bad. There was significant difference in accuracy between two groups (P﹤0.05).No postoperative injury of the nerve or spinal cord was observed in two groups. Of the patients, 24 cases were followed up for 6-12 months, and no loose or breakage of the screw was detected by X-ray and CT. In addition, no delayed spinal cord injury was found.Conclusions 3D-CT navigation system can accurately guide the thoracolumbar pedicle screw implants, improve the surgical precision, and reduce complications.
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