Clinical observation on the effect of percutaneous pedicle screw fixation assisted by 2D computer navigation in the treatment of thoracic spine fractures.

Abstract

To evaluate the clinical value of a two-dimensional(2D) computer navigation system in percutaneous pedicle screw fixation for thoracic spine fractures. A retrospective study was conducted on 74 patients with acute thoracic fractures who underwent pedicle screw fixation at Fujian Provincial Hospital from January 2019 to January 2022. Patients were divided into a navigation group (n = 34) using 2D navigation-assisted percutaneous screw placement, and a conventional group (n = 40) undergoing freehand screw placement. Screw placement accuracy (Rampersaud grading), intraoperative fluoroscopy times, operative time, blood loss, postoperative pain (VAS scores), and complications were compared. The navigation group showed a significantly higher screw accuracy rate (Grades A-B: 94.1% vs. 79.2%, P < 0.001). Fluoroscopy frequency (8.0 ± 1.1 vs. 16.0 ± 2.0, P < 0.001), operative time (90.1 ± 15.5 min vs. 98.1 ± 14.2 min, P < 0.05), and blood loss (50.4 ± 11.1 mL vs. 110.3 ± 17.8 mL, P < 0.001) were all significantly lower in the navigation group. Postoperative VAS scores were significantly lower at 1 week and 1 month (P < 0.001), with no difference at 3 months. Complications included 9 cases of transient neurological symptoms and 2 cases of screw loosening, all without lasting sequelae. 2D computer navigation-assisted percutaneous pedicle screw fixation improves screw placement accuracy, reduces radiation exposure, and facilitates early postoperative pain relief. These findings support its potential as a practical tool for managing thoracic spine fractures.