C arm

Patients were prospectively enclosed in this study, and randomly assigned to fluoroscopy (n = 18; C-arm, Siemens, Berlin, Germany) or navigation group (n = 19; O-arm, Medtronic, Minneapolis, MN) pursuant to which method was indicated preoperatively by a single senior spine surgeon (RR). All cases underwent a posterior spinal surgical approach for pedicle instrumentation at our institution between 11/2016 and 11/2017 by the same surgeon (RR). During the navigation cases an initial scan was performed prior to navigation and after pedicle screw placement, during which the whole OR personnel left the OR into a radiation shielded area. In non-navigated patients the whole surgery was performed fluoroscopy guided. In both groups, if necessary, interbody device implantation through a posterolateral transforaminal lumbar interbody (TLIF) approach and alignment correction was performed fluoroscopy guided after screw placement, which was not part of the study measurements any more. Anesthesia team left the OR into a shielded area during radiation emission in both study settings and was therefore not included. Patients’ demographic data (age, BMI) and surgery specific data were collected for the study.

Operating system of PKP, concentration of 1% lidocaine hydrochloride injection (Suicheng Pharmaceutical Ltd.), ECG monitoring equipment, Siemens C arm and related protective equipment, sterile operating articles, etc.