Abstract Reliable pedicle screw placement is central to achieving stable fixation in thoracolumbar spine fracture surgery. Conventional C-arm fluoroscopy provides two-dimensional guidance and exposes operating room personnel to radiation, whereas O-arm–based navigation offers three-dimensional intraoperative imaging with potentially improved accuracy. This study compares functional outcomes, pedicle screw accuracy, fluoroscopy use for operating room personnel, and complications between C-arm fluoroscopy–guided and O-arm navigation–guided posterior fixation in thoracic and lumbar spine fractures. This prospective comparative study included adult patients with traumatic thoracic or lumbar spine fractures undergoing posterior pedicle screw fixation. Patients were allocated to either C-arm fluoroscopy–guided surgery or O-arm navigation–guided surgery based on imaging availability. Functional outcomes were assessed using the Visual Analog Scale (VAS) and Oswestry Disability Index (ODI). Pedicle screw accuracy was evaluated on postoperative computed tomography using the Gertzbein–Robbins classification. Secondary outcomes included operative time, blood loss, fluoroscopy time as a surrogate for radiation exposure to operating room personnel, and postoperative complications. Statistical analysis was performed with a significance level of p 0.05). O-arm navigation significantly improves pedicle screw accuracy and reduces fluoroscopy use for operating room personnel without compromising functional outcomes. Despite longer operative time, O-arm navigation represents a valuable adjunct in the management of thoracolumbar spine fractures, particularly in complex trauma cases.
Gupta et al. (Thu,) studied this question.