Comparison of 3D C-arm fluoroscopy-based and CT-based navigation systems in the lumbar pedicle puncture:in vitro experiment on a cadeveric lumbar trunk specimen

Objective To compare the accuracy and operating features of 3D C-arm fluoroscopy- based and CT-based navigation systems in the lumbar pedicle punctures.Methods A specimen of cadaveric lumbar trunk underwent lumbar pedicle punctures at the levels of L3,L4,and L5 under the guidance of the 3D C-ann fluoroscopy-based and CT-based navigation systems.During the procedure C-arm fluoroscopy was used to monitor the accuracy of the puncture.Generally,in comparison with the 3D C-arm fluoroscopy-based navigation system,the best operation route and protocol could be drawn up pre- operatively,matched registration needed to be renewed for each vertebra,and the images thus obtained were of high quality in CT-based navigation.Results Both navigation systems had excellent accuracy in the guidance of lumbar pedicle punctures,and had different operating features.Conclusion Both navigation systems had its special advantages.The operating process of the 3D C-arm fluoroscopy-based navigation system was more convenient and rapid,and suitable for percutaneous vertebral puncture.CT based navigation system had clearer pictures,especially for the osteoporotic vertebral bodies,and it had less requirements for the equipments.